HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
AL,
ull dingPermi pp i on
Planning and Development Services
Building and Code Regulotion 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, ul'�ck arrow at the end of line
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t *C.,
Address: tiz
Legal Description:
5? 2-1
Property Tax ID #: 3 3 2Z -.m CC 21 0 Lot No.
Site Plan Name:. Block No.
Project Name:
�i
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
C4- L J
o CA c cf,- S t c
CONSTRUCTION INFORI'VIATION.
Additional work to be i3ertormed under this permit — check -all
I OHVA C Gas Tank Gas Piping In Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof I I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ co
Sc. Ft. of First Floor:
Utilities.- Sewer _Septic
Building Height:
OWNER VLESSEE-
�CO -NTRACTOR,-
Name r J
Name- cw t cl, k f)4 Cr
Ad V4
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Company: E�� AC. �,�erv*i
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nth
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City: state:
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address.. ki t)'e i
Zip Code: Fax:
City: -Pot luck State:
Phone No. '7 -1 7
-3q -3!S11
Zip Code: Fax: i
E -Mail:
Phone No. 12Z- %-71
Fill in feesimple Title Holder on next page if different
E- M a i I -P t 40 NEA, 1 ax.se-r Vi Cern
from the Owner listed above)
State or County Li cense: . C. 6 Cl- I % I 16
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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N LIEN A%- A 'A7 iONV
DESIGNER/ENGINEERr, Not Applicable MUkTlY,0 Not Applicable
Name- Name:
Address: Add res,�k,
City: Stalte-: City: -State.,,
zip: Phone Zi P Phone-..
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address.-- Address:
City�o 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
commenciniz w
DA or recordir)g_your Notice of Commencem_
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of A, 20 11' by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
AIL
(Signature of Pe8't'ary Public- State of Florida
al)
F�M
Daniel F 906496
SignatuWof Contractor/License Holder
S71 E7, 0 F 'F1 0 1 FR,31 0 Z�` A'111,
C C D L �' PM4 T
The forgoing Instrument was acknowledged before me
this day of - -AV!40 S+ -__p 20 f Fk by
- avvi(A'
Name of person making statement
Personally Known X — OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub RCState of Florida
Com
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- - ' 1"ZONING PERVISOR I PLANS
FRONT
COUNTER REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
StMe ot SwWa
Michelle Daniel
M
Y COM 004
mission' FF 996
7'EfATIO NMANGROVE
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REVIEW REVIEW REVIEW
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed h service between Feb 17,2009 and Dec 31, 2016.
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AHRI Certified Reference Number: 201441988 Date: 08-20-2018 Model Status: Active
Old AHRI Reference Number: 8996162
AFIRI Type: RCU-A-CB
Series: GSX1 6
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package): GSX1 60481 F*
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, 11p IAP IN, KS, KY, LA, MA, MD, ME, Ml, MN, MO, MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, VVI, Wy, U.S.
Territories)
Region Note Central a�r conciftioners 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.
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Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 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 : 45500
SEER: 16.00
EER (A2) - Single or High Stage (95F) : 13.00
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.
Ratinds that a,rJ WAS inqU an involuntary re -rate. The new published ratina is shown
j with the Wreviou.3 i.e. WAS rating.
=Z:M-3.1 WMEWEMN
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. AHM 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
TERMS AND CONDITPONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and
confidential reference puvposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated;
entered into a computer database; or otherwise utilized, in any form oV, manner or by any means, except for the user's individual,
personal and confidential reference, AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGBRIATION INSTITUTE
The information for the model cited on this certifirmtoGan be verified at www.ah rid! rectory, org, (;I!Gk on "Vorify Certificate" link we make life beWer-
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
which is listed above, and the Certificate No., which is listed at bottom right. F_
@2018Air-Conditioning, Heating, andRefrigeration Institute I CERTIFICATE NO.: 131792661787011971