HomeMy WebLinkAboutbuilding Permit ApplicationALL APPU BLEf fNFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 1 Permit dumber:
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
PRC3POSEt] llVlPl UVEMENT LOCAT1D111._
Address:
Legal Description:
C.
/C. Ch"e_ caw ! 1 c k e r C( -/cam l f( SC,CfL I Cho,,n�?tbO ,_� -q8(4 � ►, A '( c� � T�
10 Kw it,,J, 3, -,5 60 ,
COIVSTRUI"TIOlV:N1=QIMATICiN
Additional work to be nertormed L ert tspermit-checka appy:
CJHVAC0 Gas Tank DGas Piping _ Shutters j� Windows/Doors
0 Electric 11 Plumbing t.J Sprinklers ® Generator L=1 Roof Roof pitch
Total 5q. Ft of Construction: " 5 . Ft. of First Floor.
Cost of Construction: $ � Utilities:aewelleptic Building Height:
OV►fNFR/LESSE1r
yCONTtACTUI
fVarne�c�,��e(?,�e.�
Address: 1
City: Pi erL-e_ State: Ftr
Zip Code: k1 Fax:
Name: mac- i - r^fRc
Company: Hdf�lcrrfz�; r- Ak- 471WC I rl ^:5t4 � 00aIS
Address:1001 C Yi' e_ .,4- &0
-
City: fes+ P, State:
PhoneNo,
_
Zip Code: 3L/1t i5, -J- _044
E -Mail:
Phone No.7 3 — /QQLa
Fill in fee simple Title Holder on next page (N different
E -Mail: i Id,r hC,4M4,1 -
from the Owner listed above)
State or County license: L1411 UfaCv
It value of construction Is 525M or more, a RECORDED Notice of Commencement is required.
WOO, LE /IEN.fAL-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 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 usesto 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
comrnencine work or recording your Notice of Commencement.
r,71
'r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA -
COUNTY OF -_ ,ice'. ]C-' ['C sc kC.i '
STATE OF FtO - —a
COUNTY OF . `
The forgoing instruArient was acknowledged before me
The for Ding instrument was acknowledged before me
this day of :` 2U, by
this day of 20jF� by
Name of person making statement
Name of person making statement
Personally Known ') OR Produced Identification
Personally Known . )�_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
{Signature of Notary i
(Signature of Notary Publi
0 NAM. HILI,
��a••...'..''•.: DONNAM. WILL
Commission N CoJ N GG 099o3t3
EXP
SION # G� 089038
Commission N • - �:
ES: prii 30, 2021
N'Hondo Thn, = P+rhlic findens7Hars
April 3o. 2021
'h +Siia�' ` 601Edesf i�FN ttiuf8ry PpbftC Ul1deRYd
9t5
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 812/17
(SEE
Certificateof ProductRatinas
AHRI Certified Reference Number: 8446337 Date: 08-08-2018 Model Status: Active
AHRI Type: RCU A -CB
Series : LX SERIES
Outdoor Unit Brand Name: COLEMAN
Outdoor Unit Model Number (Condenser or Single Package) : TC484221
Indoor Unit Model Number (Evaporator and/or Air Handier) : AP60CX21+TXV
Region : Southeast and North (AL, AR, DC, DE, FL, GA, Hl, 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 COLEMAN product is responsible for the rating of this system oombination.
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 : 41000
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.25
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
Ra -
bn s that are accompanied by WAS indicate an involuntary re -rate- The newublished ratinri is shown along,
with the Previous i.e. WAS) 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 product(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed 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
opied; disseminated;
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; c `
entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for th
personal and confidential reference. e user's individual,
AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION&REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at www.ahridirectory.orgr 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.
02018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE Nn . 131782207028833736