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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2J C-4 Permit Number 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 �� PRQPQ­SEU1MP4€?U ENT IrOnA A21- Address: Legal Description: bAJ .& (-�( / L 04 15 LP C(() c) k) L-0�- / A u,)k 1-2y) A- A&er-IT6- - La; QJL Property Tax ID #. &AQ -3 -5-22- -OlGq— OW La Lot No. Site Plan Name- Block No. Project Name: Setbacks Front Back: flight Side: Left Side: K." 4k, �lKcn� e-- c> u-� ECIC Lrk-(h 6-1-vtp cy) r S -Tc,-q 6 (00 a4 U I 1�� Cl 21-1 CONST - RUC .1 Addit a wor to be performed ungert is permit --c ec all apply. (PAc GasTank�E]Gas Piping tnShutters 17Windows/Doors 08ectric R Plumbing [:]Sprinklers ElGenerator 11 Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ — ,Sq. Ft. of First Floor: Utilities: USewer[leptit Building Height: OWNER/LESSEECON N a m e C41, C, CIAL Name: :2122 UE-`T Address: JC)?:?,drn:C-1 Cbrnpany.-"6a4,,,,, Ale- 6 -C -k City., Pepe e— State. Address-6po I !�J &,C - Zip Code: 3c/9 9,7- — Fax: 014 City: 61- 19,-efzs State: rL Phone Na. 22a --Y-2- 0 Zip Code: _aqImoF?-a- E-Mail: Phone No. 7) 9 -4/&5--- /U0 Fill in fee simple Titile Holder an next page ( N different E -Mail: AJ",,, "I k,", —&Nn— from the Owner listed above) State or County License: el &o94v Locl, If value of construction Is $2500 or more. a RECORDED Notice of Commencement IS TOnUirad- Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: Ui�cTlQl'rl=. - - MORTGAGE COMPANY. NOt #Applicable Name: Address: City: State: Zip: Phone; BONDING COMPANY: Not Applicable .Name; Address: Zip- Phone: OWNER/ CONTRACTOR AFFIDVIT.- Application is hereby made to obtain a permit to do the work and inset t ruon as indicatec I certify that no work or installation has commenced prforto Me issuance ofa perrrrrt 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 Dome 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 raview- 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 tMce 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 tairth lender or an attorney before commencine work or recordfne your Notfee of Commencement. Rev. 8/2/17 Signature of Owner/ tehee/Contr-acttor as Agent for -Owner sgnattire of Contractor/License Holder STATE OF FLORIDA - STATi: +< FKO A COUNTY OF COUNTY OF The f©r oing 1nsbVnentvras a powledged before me this day The forgoing instrument was cknowledged before me this 3 day of"s�20 by of 20 by a r Name of person making stafiernent Name of parson malting statement Personally Known OR Produced ldentrfication Personally Known: _ OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary (Signature of Notary Pubs ,•. '� 141. HILL OONNAM. tilt L Commission N COGG089a38 Commission N-ON#GG099038 P� 3D 2DI27 "��Ih�d Apn� 30, 2024 QOndedd�lr'FubltcUrCderxaiter. REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 Certificate of Product Ratinas AHRI Certified Reference Number: 8908415 Date : 08-23-2018 Model Status: Active AHRI Type: RCU-A-CB Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC7136021 Indoor Unit Brand Name: CHAMPION HEATING AND COOLING Indoor Unit Model Number (Evaporator and/or Air Handler) : AHX61 Region - All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, EL, 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 CHAMPION HEATING AND COOLING product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSIIAHRi 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 (9517), btuh : 52500 SEER: 16.00 EER (A2) - Single or High Stage (9517) : 13.00 t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND s0ing 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 Stijl selling or offering for sale. Rahn s that are aceom anied by WAS indicate an involunta re -rate. The new Published rating is shown along.with the Previous i.e. WAS ratin . 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 fpr 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, personalandBin 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, JrMN personal and confidential reference, AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information far the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better - 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. ©2018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 131795126566445572