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HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ' - a_ Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: li6irk -.} r' Legal Description: .C. sy' f Loy. st --2�-. a V-kD a �' �; . Property Tax ID#: Lot No. Site Plan Name: Block No. Qli Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 00 .�i . CONSTRUCTION INFORMATION: 7itip ria wor to e e orme under this pe mit r -c ec a app y: VAC Gas Tank Gas Piping _Shutters 0 Windows Doors 11 Electric Q Plumbing O Sprinklers Generator 0 hoof Roof pitch l Total Sq. Ft of Construction:_ _ S . Ft. of First Floor: Cost of Construction: $ 1° Utilities: Sewer Septic Building Height: OWNER/LESSEE: _ CONTRACTOR: Name `1.L,, Name: Address: L Company: , (4�'— City: ~ A- cccj�-- State: e.-fj Address: Zip Code:_y -ir — Fax: City: ' Stater Phone No. l-yt� Zip Code: s �" ? Fax:i Y E-Mail: - "`^' Phone No. Fill in fee simple Title Holder on next page ( if different E-Mail: SEe- 4 t! �a , ren—C.}' from the Owner listed above) State or County License: i If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ,Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: (Name: Address: Address: City: City: Zip: Phone: Zip: Phone:_ OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated_ I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls, signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Si of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/license Holder STATE OF FLORI A STATE OF FLO, DA COUNTY OF ,(Ylti�^�i1 d _. COUNTY OF The forgoing instrument was acknowledgeo before me The forgoing instru ent was acknowledged before me this.�day of '1 . 20 t by this �(''�day of +''► 20 t by Name of perso &king statement Name of per on ing statement Person n oduced Identification Personally Known OR Produced Identification Type o I enti ica Type of Identification d uce y (Signature of Notary Public- to of Florida) (Signature o otary i'ublic- 4 Commission No. bs PCASLADE Commission No. , �br�t4#GG 599 ,; MY COMMISSION i#GG 159120 «; EXPIRES:January 20,202Z °�' o QP. EXPil31 ;Jrluary20,<{ y F G° 8unded TAni Notry Pubk Lh& g4°` Bonged Thus Na Pudic Urwi"wMers tKPIVM REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 _ BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982 ® 772-462-1553 FAX 772-462-1578 AUTHORIZATION FORM FOR CREDIT CARD PAYMENT TO: St Lucie County RE: Permit # Credit Card Users: 1,5% Surcharge added per transaction. Payments must be received in this department by 4:00 PM for transaction to be process that day, if not it will be processed the following business day. VISA MASTERCARD Credit Card Number �Icll Expiration Date 06, Zip Code - 3 digit security code a ` Amount $ + 1..5% surcharge Business Name: - Authorized Signature: 1 Print Name. isLx'1 Phone: Fax: t ) -- Comments: SLCPDSD Revised 4/01/2010 EN FLORIDA ENERGY COHSE VATM CODE Mandatory Duct Inspection Certification for HVAC change-out For use when part of the duct and/or HVAC system has been replaced(Section 101.4.7.1.1&FS 5533.912) {)caner: Contractor name: tl' Street address: A t Jurisdiction: City- Pennit No.:zip—Final inspection date: I certify that I have inspected the duct work associated with the HVAC unit referenced by the permit listed above and found it complies with the requirements of Section 101.4.7.1.1 as indicated below: CQ Where needed,the existing ducts have been sealed using reinforced mastic or code-approved equivalent. ❑ Du re cated within conditioned space. (Section 101.4.7.1.1 exception I) The joints loor seams are already seated with fabric and mastic(Section 101.4.7.1.1 exception 2) R System was tested(see below)and repairs were made as necessary—(Section 101.4.7.1.1 exception 3) Signature: Printed Name: Contractor License#: ----------------------------------------------------------------------------------------------------------------------------- I certifies!I have tested the replaced air distribution system(s)referenced by the permit listed above at a pressure differential of 25 Pascals (0.10 in. w.c.). Signature:e bate: Printed Name: I Form revision date:March 18,2011 ru Gal ILAMIN 'i certificate of Product Ratings AHRI Certified Reference Number:8437278 Date:06-25-2018 Model Status:Active AHRI Type:RCU-A-CB Series:LX SERIES Outdoor Unit Brand Name:JOHNSON CONTROLS Outdoor Unit Model Number (Condenser or Single Package):YCE36B21 Indoor Unit Model Number(Evaporator and/or Air Handier):AP36BX21+TXV Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS, NC,OK,SC,TN,TX,VA,AK,CO,CT,ID, IL, IA,IN,KS,MA,ME,MI,MN,MO,MT,ND,NE,NH,NJ,NY,OH,OR,PA,RI,SD,UT,VT,WA,WV,Wl,WY,U.S. Territories) Region Note: Central air conditioners manufactured prior to January 1,2015 are eligible to be installed in all regions until June 30,2016.Beginning July 1,2016 central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. The manufacturer of this JOHNSON CONTROLS product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSIIAHRI 2101240 with Addenda 1 and 2,Performance Rating of Unitary Air-Conditioning&Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(A2)-Single or High Stage(95F),btuh:34000 SEER:14.00 EER(A2)-Single or High Stage(95F) :11.75 t"Active"Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are being marketed but are not yet being produced.°Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratin s that are acconn anied by WAS indicate an involuntary re-rate. The new published ratinq is shown alon2 with the previous i.e.W SI rating. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the prodoct(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations fisted in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole as in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual personal and confidential reference, , AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life better" which is listed above,and the Certificate No.,which is listed at bottom right. — ©2018Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 131744292719166393 i r s i i " g s if f • i yy ICI - h S I ri 1 1 These products are our answer to Protecting dine sets exposed to the elements.Although different in application,they both meet code requirements being adopted across the country, flMP to ons'"i e � ll Choosing a4� E""N O s s Why choose TPO Litre Set Wrap? The TPO rolled mastic sealant is a 6.5 mil TPO membrane —_ larninated to a butyl adhesive sealant to form a 22 mil composite. p. �°°r°�•** The TPO Line Set Wrapapplied b g-is PP y peeling off the release liner ". while covering the pipe wrap insulation.Since this membrane is 100%solid,there is no shrinkage or additional coats required due to absorption by the insulation.This gives the product superior Protection against damage from moisture, landscaping operations, equipment maintenance,and wind. Both Products provide excellent LIV protection Why choose SEAL-TACK White? SEAL-TACK is an easily applied water based coating engineered to + Ljn . : createS coat foam insulation and seal cut ends of fibrous glass duct liner. IMpact It allows the foam insulation to remain flexible while providing excellent weather and sunlight protection. USA:900 Hensley Lane,Wylie,TX 75098•(877)495-4822 erg y : HV C IW Canada:2100 Remembrance Road,Lachine,QC H8S 7X3•(800)544-5535 ArT'L717�,1.r 6 L>ZGT 5�.1 WTa ry.I:SU ATfOs1 FnHE5f4'u5 www.carlisl'ehvac.com CMislc.liard.,[and SrAL-TACK.M lradc rk,of Ca I.s,.020%Carlisle.PIN W2340-rxrerior Line Set Prodeczi0n Sell$hest- -_