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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phorrlie: (772) 46e-1553 Fax: (772) 462-1579 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR4PQSED 11V�PF�QVEM,ENT i-QCATi�]N.. ` - - Address: Legal De - /aCO7� Property Tax ID #-..43L2 - -,0)7D I - 0139 COD c2= - Lot No. Site Plan Name: Block No. Project Name: Setbacks Frarit Back: Right Side: Left Side: Ct]NSTRUCTION: IIVFRMATION Afftflt1nn21W0r1CMnPnPrtnrM0Atui art �c r�armi} .. r eet inn v 1 VAC U Gas Tank - []Gas Piping LJShutters [] Windows/Doors Electric E-1 Plumbing Sprinklers 1:1 Generator ® hoof Roof pitch Total Sq. Ft of Construction. Cost of Construction. $ /-/Q[ 0 S Ft. of First Floor _ Utilities:OSewer LJS.eptic Building Height: DINNER/IESSE CONTl4C1'OR: Name Name: T Address: Company: City State: s?C .rZ Address: &L91 Zip Code: ti %LA ,A - Fax' --L2 Z4 _ b`� Cit1►= - State' Phone No a- 2 W,;L/`/ _.,. Zip Code: g� .. Fax: -22-2 E -Mail: Phone No.7 ?4 - y`GrS- (pc�CP Fill in fee simple Title Holder on next page t N different E -Mail. . (� from the Owner listed above) State or County Uc"ense: - - - �. �.,..,• .....��.. ,a ,v, ,uu us chum, a nc..vnucu mouse of WMFnencemeni is requlrea. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER; Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone Address: City: State: Zip: - Phone; FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: Ail ffif cff 1 f•Af.lTf R/.rst.. Personally Known `)S OR Produced identification —rou-ni %.will f F%m%. f uR mrreuvi 1: 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 5t. 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 commencina work or recording vnrlr NritirP of f`nrnmanrpm ont nvv. 01c1ii Signature of Owner/ Le see/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA , - COUNTY OF ' ? STATE OF FL01tiCIA COUNTY OF_ The forgoing instrument was ac l nowledged before me The forgoing inti went was Iknowledged before me this,20 day of 2016 by this c)Q clay of 201& by Name of person making statement Name of person making statement Personally Known `)S OR Produced identification Personally Known. X OR Produced Identification Type of Identification Type of Identification Pr[!{ooddjuced Produced L\{ 1 f1 0"", (Signature of Notary i (Signature of Notary Pubii ; � ...•.,-., NAM. HILL Commission N �+7 co N N # GG 099038 EXP ES: April � �:•--•rkt Ds3NNAIN. HILL Commission N ' n�v s14N # GG 099038 F .,..; 30, 2021 �,�:•• Bonded lhru Notary Pubic Wderwffters : Ap ril 30 2021 '�AfA°'� 90"ded An' Na ��'" Lary Public Undefwrlters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE CONIPL' TED nvv. 01c1ii +van:i CERTIFIED° www.ahridirectory.org This combination qualifies for a Federal Energy Efficiency tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Product Ratings AHRI Certified Reference Number: 8900215 Date : 08-20-2018 Model Status : Active AHRI Type: RCU-A-CB Series : LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC7B3021 Indoor Unit Model Number (Evaporator andlor Air Handler) : AE36BX21+TXV Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, fL, IA, 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, WI, WY, U.S. Territories) Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be installedin 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 CHAMPION HEATING AND COOLING 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 : 29200 SEER: 17.00 EER (A2) - Single or High Stage (95F) : 14.25 1 "Active" Model Status are those that an AHRI Certification Program Participant is currently producing AN D 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 o 65ering for sale. 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 o€ any kind arising out of the use or performance of the product($), 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.ahridirectofy.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and sseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's ua confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; di personal and confidential reference. individl, CERTIFICATE VERIFICATION AIA -CONDITIONING, HEATING., The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link & REFRIGERATION INSTITUTE and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life better^' which is fisted above, and the Certificate No., which is listed at bottom right. ©2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE Nr) • 131792704935542542