HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
",
CUNT
BuildinR Permit Annfiratinn
Dl"^ ;*,
" g and De etopment 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, clic
k arrow at the end of line
PRO,POSE D I'M`PR0VEMENT LOCATION:
C ram
Lt111) li,
Address: Wk ��E
Legal Description: ell
3) 76-7-2Z5
I q 0 w_331 S
C)
2 C
Property Tax ID #:
Site Plan Name. -
Project Name: Zis No.
Setbacks Front ----------------- Back: ------------- Right Side: --- Left Side.-
--------------
DET AILED DESCRIPTION OF W
aRK:
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CONSTRUCTION INFORMATION
lio:t
Itional work t �er �or n.
o be ea uncler this mit —
p6rm't — c ec
WHVAC Gas Tank
a appy
11Electric Plumbing
Gas Piping
Shutters Windows/Doors
Sprinklers
Generator Roof J Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $
Utilities:
Sewer Septic Building Height:
OWNER/LESSEE,
CONTRACTOR.
cl-kl-
Na m e:
Address: I
it- UC
Cy: eor-) 34-
Company: C S,\& LL C,
2,�L/ci,�
Zip Code:
State:
Add re 532- �)(L) dovem+; �,.
City: J r 1110
Phone No. 7, 2� 32-3 -a/ 1-`1
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q 9; State:
Zip Cocle: a L__7 F'7'?Q -613
ax:
/ref`[ e® l:
Phone No. 1-7z— %-71
Fill in fee -51rnple Title Holder on next page if different
E - M a i 1: (" of Col. /n
from the Owner listed above)
State or County License: chc 1 %0 6 a3 I
if value of construction- is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
► - . UIMIF1411��n
City: State:
Zip:
..... Phone. -
FEE SIMPLE TITLE HOLDER: No
Namet Applicable
:
Address . -
City:
Zip*-, Phone:
MORTGAGE COMPANY: Not Applicable--
Name--
Address,,
City:
Z i p P h o n e
Not'ApplJocc-@tet`
e
N a m e
Address-,
city..---- �-_
Phone:
uwr,dt:K/ CONTRACTOR AFFIDVIT: Application is hw
I certify that no work or installation hereby made to obtain a permit to do the work and Installation as indi.
as commenced prior to the issuance of a permit. coted
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 I I 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
ithat I will, in all respects, perform the work
n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoin
accessory structuresg a full concurrency review: room additions,
., 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 �absite
before the first inspection. If you intend to obtain financing, con
commend or recording _ r Notice of sult with lender or an attorney before
_yot
i — j Commencemert.""--�_,
Signature of Owner/ Lessee/Contractor as Agent funr Owner Signatur of Contractor/License H-oE'lder
STATE OF FLORIDA
COUNTY OF
S�,k-'(1
The forgoing instrument .was acknowledged before me
this2-S
..L'�day of 20A by
- 3�av
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
�N
�Signature of N'o—tary Public- State of Florida
• wary P -Qisie F a
Michfft Daniel
* * *. 9014911
STATE OF FLORIDA
COUNTY OF cr
The forgoing instrument was acknowledged before me
thi day of .20r6_ by
lavv i 4
Name of person making statement
Personally Known )( OR Produced Identification
Type of Identification
Produced
'(Z
(Signature of Notary Pub = State of Florida
ter- IrIr 1W 'Ir _1W IF 1W W 1r, _W W -W
Comm sl
Notwy-PWAo ftfe.WWa al)
of F
Michelle Daniel
F*J My Commission FF 906496
KhVTEV7Y'_ FRONT ZONING SUPERVISOR PLAN VEGETATION VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
L.COMPLETED _I
Rev. 8/2/17
AHRI Certified Reference Number: 9993614 Date: 07-25-2018 Model Status: - Active
AHRI Type: RCU-A-CB
Series: AVXC20
Outdoor Unit Brand Name: AMANA
Outdoor Unit Model Number (Condenser or Single Package): AVXC200361A*
Indoor Unit Model Number (Evaporator and/or Air Handier): AVPEC37C1 4A*
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, H1, ID, IL, IA; iN, KS, KY, LA, MA, MD, ME, w, MN, MO, MS,
MT, NC, ND, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, VVA, WV, WI, 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 AMANA product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 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 : 33200
EER (A2) - Single or High Stage (95F) : 12-50
t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND sellinPro or offeriP for sale's new models that are being
marketed but are not yet being produced. "Production Stopped" Model Status are those that an AHRI Certificationgram rticipant is no longer producing BUT is still
selling or offering for sale.
Rating thgt are- a2c2M2.anied Ly WAS indicate an involuntaryrre rpte. The unew -
the
DISCLAIMER ra in2.
_ ------------- t
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assurnes no responsibility for,
the product(s) listed on this Certificate. AHRI expressly disclaims al�, hability for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for mode�s and configurations listed in the
directory at www.a h ridi rectory. or�,,
TERMS AND CONDITIONS
This Certificate and its contents areproprietary products of AHK This Certificate shall only be used for individual, personal and
confidentiM reference purposes. The contents of this Certificate may n
.0t, in whole or 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.
CERTIFICATE VERIM CATION AIR-CONDITIONING, HEATING,
The information for the model cited on this certificate can be verified at www.ahridlrector',,,1j cflck on "Verify CWtificate" link & REFRIGERATION INSTITUTE
and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life betterTll
which is listed above, and the Certificate No., which is listed at bottom right.
@2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATP KII(I - 131770163629818665