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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: V 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: A ress,* ro dd _71-D + L "k n: e g a I D e s c r i p t I o f -xd, �:-A Al -J 6 Property Tax ID #: 3 4 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front , Back: . Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Y C) e'A CONSTRUCTION INFORMATION: AdET11:06­n5-1-w-or to be P rformed underthis permit - c ec a I app y: F71 HVAC LY.1 Gas Tank Gas Piping o Shutters Windows/Doors 11 Electric El Plumbing Sprinklers Generator Roof I Roof pitch Total Sq. Ft of Construction: Sc,. Ft. of First Floor: Cost of Construction: $ Utilities: -JSewer Septic Building Height: OWNER/LESSEE, CO-NTRACTOR- Name Name. a,.� CL AAgLq s s: 1,110 e:> c Company: 4C Se LL C q r, v i Cit Y: State.'El Address: 532- QUO Ji i -n+1 le, PL Zip Code: Fax: city: Lat-i Y,-, J -u C, k, State:- Phone No.,*A Zip Code: Fax. E -Mail: Phone No. '72Z-1. V71 A5W Fill Mn fee 5imple Title Holder on next page if different E -Mail: mfo from the Owner listed above) State or County License: chc I If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. OWNER/ CONTRACTOR AFFID VIT: 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 vou intend to obtain financing, consult with lender or an attorney before cornmencinp, w &A or recording yo Notice of Commencem Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF The forgoing instruKnent was acknowledgO before me this2Z day of -JA Q Cku-,04 20by Name of person making statennent Personally Known X -OR Produced Identification Type of Identification Produced. 4Signature of tovary Public- State of Florida Daniel 'iF 90496 SignatuWof Contractor/License Holder STATE OF FLORIDA t�u , T� -� '�_ - Ir COUNTY of " r The forgoing instrument was cknowledged before me this'day of 20_4 by f LA, Name of person making statement Personally Known X OR Produced Identification Type of Identification Produced (Signature of Notary PubH6 State of Florida ) X-OT171 L ktVrn5W W'W - FRONT ' - '20'N!`G SUPERVISOR PLANS COUNTER REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 nwal y r ---w- Michelle Daniel .Z My Commission -IFF 906496 'INAi, A N G 0 V E GPTATION SEA TURTLE REVIEW REVIEW REVEW If '-4 R 1.0'. v\l i W "j t, I L A �kv - N IKIIN i vu, DESIGNER/ENGINEER: Not Applicable hP.ORTA GE COMPANYO Not Applicable Name: N a m e: Address: Addres'50, City: St, e0 city6o S) t alt, e Zip: Phone ZIP -Q '­_­ an e FEE SIMPLE TITLE HOLDER: Not Applicable D8 0 Ffi, IF —Not ApplicaNe Name® Namea Address'., : City _ - _w_Address Ci zip.. Phone.-- . Zip: Phone : OWNER/ CONTRACTOR AFFID VIT: 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 vou intend to obtain financing, consult with lender or an attorney before cornmencinp, w &A or recording yo Notice of Commencem Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF The forgoing instruKnent was acknowledgO before me this2Z day of -JA Q Cku-,04 20by Name of person making statennent Personally Known X -OR Produced Identification Type of Identification Produced. 4Signature of tovary Public- State of Florida Daniel 'iF 90496 SignatuWof Contractor/License Holder STATE OF FLORIDA t�u , T� -� '�_ - Ir COUNTY of " r The forgoing instrument was cknowledged before me this'day of 20_4 by f LA, Name of person making statement Personally Known X OR Produced Identification Type of Identification Produced (Signature of Notary PubH6 State of Florida ) X-OT171 L ktVrn5W W'W - FRONT ' - '20'N!`G SUPERVISOR PLANS COUNTER REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 nwal y r ---w- Michelle Daniel .Z My Commission -IFF 906496 'INAi, A N G 0 V E GPTATION SEA TURTLE REVIEW REVIEW REVEW fm A Ratmi-nii- 7A,,..s Cer,, t,,mif icate of Product AHRI Certified Reference Number: 201441939 Date : 08-20-2018 Model Status : Active Old AHRI Reference Number: 8996155 AHRI Type: RCU-A-CB Series: GSX16 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX160301 F* Indoor Unit Model Number (Evaporator and/or Air Handler) : AVPTC37C14A* Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, 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 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 GOODMAN product is responsible for the rating of this system combination. 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 (9517), btuh : 28600 SEER: 1.6.00 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. elfin s that are accom anied b WAS indicate an involuntar re -rate. The new ublished ratina is shown alona 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.ahrldlrectary.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 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, Oil personal and confidential reference. AIR. -CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at x i it t r . , cliche on " `eHfy i t " link 11 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. 131792714002493483 02018Air-Conditioning, Heating, and Refrigeration institute CERTIFICATE �'.: