HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9h /P9 Permit Number:
Building Permit Application
Planning and DevelflpmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phorfe: (772) 4521553 Fax: (772) 4521579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line
PR0P05EDD lMWVEM.ENT LQi 4ETfUJ4�
Legal Description:
Property Tax ID #: LL.n-ct- -
Site Plan Name: S ,
Project Name: U c--Yu`� , 4�
Setbacks Front Bank:
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Right Side: LeftSide:
DETAILEa DESCRIPTION t]IIidIdC
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Ct .NSTRUCTION INFO RMA7T10N1. =
ACICI Itional worK toe nerformed ern er this perms — checlK all apply: -
HVAC 13Gas Tank E]Gas Piping"``"�]} Shutters DWindows/Doors
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Electric FJ Plumbing []Sprinklers Generator O -Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor _ ^�
Cost of Construction- $ G/�'�C Utilities:Sewer LJSeptic Building Height:
OWNER/LESSEE
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Company: �r
City: arl State: FC-
Address: d�
Zip Code: We Fax:_K3
City: er State.
Phone No. AD �A- --
Zip Code: Fax:-4s!�,5-04
Phone No. 6
E -Mail: J ;
E -Mail: 0 dA-
Tall in fee simple Title Holder an next page ( if different
from the Owner listed above)
State or County License: (1oC
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable
Dame:
Address:
City: State:
dip: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COI`11IPAW. _ Not Applicable
Name:
Address:
Cibr. State:
Zip: Phone;
BONDING COMPANY: Not Applicable
l�iarne=
Address:
City:
Trp: Phone:
OWNER] CONTRAC rOR 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 issaance ofa permit-
St
ermSt Lucie County makes no representation that is granting a permitwill authorize the permit holder to build the sublaet structure
which is in conflict with any applicable Home Owners Assodation 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 vuhlch may apply.
In consideration of the: granting of this requested permit, i do hereby.agree that i will, in all respects, perforin the work
'in accordance with the approved plans, the Florida Building Codes and St Lucie County Amendments_
The fallowing building permit applications are exempt from undergoing a foil 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 WACe 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 tender or an attomey before
commencine work or recording Your Notice of Commencement. --
Signature of owner/ Lessee/Contractor as Agent forUwner
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signature of Cor#acwr/License Holder
STATE OF FLORIDASiAT CW FE0 A
COUNTY OF , ' COUNTY OF .
The forgoing inemir was adMowledged before me
this—2 day �- 20/P5 by
LLL
Name of person making statement:
Personally Known _A OR Produced Identification
Type: of Identification
Produced
(Signature of Notary P
Commission
I A►
RECEIVED
Rear. 812117
. LiONN K HILL
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EXP M. 340, 2121
8 MdedThatNitapt&&Uft&.ff.
The forgoing instpjmewas acknowledged before me
this 2_day o 2-,D_la by
Nance of person rnakingstatement
Personally Known - C OR Produced Ideniffication
Type of Identification
Produced
(Signature cif iVotary Qubl Rhcp
M. HILLCommission N - MN#GS092 8rtl30, 24121
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FRONT I I PLANS VEGETATIONTURTLE
EA
Cd LATER REVIEW 5 RPEVIEWOR REVIEW � REVIEW � � REVIEW I PANGROVE REVIEW
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certified Reference Number: 8900648 Date: 09-07-2018 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) : TC7B3621
Indoor Unit Model Number (Evaporator and/or Air Handler) : AE36CX21+TXV
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 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 : 34600
SEER: 16.50
EER (A2) - Single or High Stage (9517) : 14.00
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.
Ratings that are accompanied by WAS indicate an involuntary re -rate. The new published rating is shown along 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.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, JU RM
personal and confidential reference. 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 �T make life hetter-
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.: 131808215900653540