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HomeMy WebLinkAboutKenAdamsPermitApp ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 f 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 and of line PRt?R©SE 11NlPROVEMEN. LOCC.�4T Address:•� Q /C c-t Legal Description: r 1 � dLl�f Property Tax ID#: U 1 -- © U- 0(3CD- 9 Lot No. Site Plan Name: LcrJ Block No. -,2(, Project Name- Setbacks Front Back: Right Side: Left Side: DETAILED I31=5CRIPTIQN 0 _WOIIG. CONSTRUCTION:INI= RMAT_ION- 77771 ; AGUitionalworictoDenertormed ,, un ert is permit—check a apply: OHVAC OGasTank E]Gas Piping Shutters O Windows/Doors 01 Electric Plumbing []Sprinklers ®Generator 13 Roof Roof pitch Total Sq.Ft of Construction: S .Ft.of First Floor-_ Cost of Construction:$_,E 20-O �� Lltilitles:llSewer USeptit - Building Height: OWNER/frESSEE ;. `: .CONT# ACTOR: Name-ELod Namel�i6. Address 0 City. � State:�� Address: J• Zip Code:3t/9 t17 -� Fax: !y// - City: r(,0- lei-C-e _._..State: Phone No. lq- Zip Code:_3419CT-v- Fax:-/�a-U&T- — E-Mail: A- Phone No.77.,)-~ yids- / f� ^ Fill in fee simple Title Holder on next page(if different E-Mail: k L i66 ,hd rrra P� • �,y,� from the Owner listed above) State or County License: 4 Cv i L valve of construction is$25013 or morn,a RECORDED Notice of Commencement is required. SU � kt C{)l S t3£ v EN_ ��oR A_M'0l DESIGNER/ENGINEER.- : Not Applicable MORTGAGECOMPANY: vNot Applicable Name: Name_ Address.• Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER; Not Applicable BONDING COMPANY: Not Applicable Name: Marna Address: Address- .— City: City: Zip: Phone: Zip: Phone: OWNERI CONTRACTOR AFFIDViT.Application is hereby madeto obtain a permit to do the work and installation as indicated I certify that no work or installation has commencer)prior to the isswance ofa 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 roncurrency review:room additions, accessory structures swimming pools,fences,walls,tigns,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 roust be recorded and posted on the jobsite before the first inspection.If you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lgsee/Contractor as Agent for-owner Signature of Contractor/Ucense Holder STATE OF FLORIDA STATE'0FFLG A COUNTY OF COUNTY OP e, The forgoing instrument was ac cr�owledged before me The forgoing instrument was acknowledged before me this 3t day of 2a 18 by this :1_ ( day of ,20 18 by s . Name of person malting staternent Name of person maldngstatement Personally Known ')S _OR Produced identification Personally Known OR Produced Identification Type of Identification "type of Identification Produced Produced (Signature of Notary P i� NA61.F!1!L (Signature of Notary Pubi t?oi+lliA(N.lI1LL Commission N r •• coh fdG 088038 Commission N - E��l `.'Iph1 [=G 099i138 . EXP ES 30,221 Apn130,2021 �,.� * [3andedi7tnr EataryPtd�ictJnde eORdedTft114ftyPV*undemftu REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED MATE COMPLETED Rev.8/2/17 AsNalmal 1 r rg Certificate of Product Ratings AHRI Certified Reference Number:8457359 Date:08-31-2018 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):TC4B3621 Indoor Unit Mode!Number(Evaporator and/or Air Handler):AP36BX21 fTXV Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,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,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 ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air-Conditioning R 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:34000 SEER: 14.00 EER(A2)-Single or High Stage(95F) : 11.75 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. Ratin s Ph at are accom anied by WAS indicate an involuntary re-rate. The new iaublished rating is shown alono with the previous i.e.WAS satin . 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 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, personal and confidential reference. ArqW AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information forthe model cited on this certificate can be verified at www.ahridirectory.org,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. ©2018Air-Conditioning,Heating, and Refrigeration institute CERTIFICATE NO.: 131801885138043841