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HomeMy WebLinkAboutBuilding Department ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � //� Permit Number: Planning and Development Services Building Permit Application Building and Code regulation Division 2300 Virginia Avenue, Fort Pierce FC 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 Address: Legal Description: Property Tax ID #: Site Plan Name: 0 Project Name: -?off -DiLIZ-Ci -I �`'� - ''n ' -- Setbacks Front` Back: -__ Right Side: _ Left Side: Lot No. I Block No. t�La-+3y8'al , �iVy9�E 3ai-r-e� n'-0" (+HVAC ""-- Gas Tank wI UV1 UI1-I Perrrnt—cnecK aii ❑Gas apply; CElectric Plumbing Piping I Sprinklers _ Shutters Generator Total Sq. Ft of Construction: S, Ft, of First Floor: _ Cost of Construction: $ 2C_7(.2 UtilitiestSewer ©Septic Name Address:(0} City: State: [� Zip Code: F-C190� Fax: &3 Phone No. lU /A- E -Mail: t 7 4 - Fill in fee simple Title Holder on next page f if different from the Owner listed above) Name:., Company: I 1L Windows/Doors Roof Roof pitch Building Height; �t Address: r�I&:e= City: State: /7z- Zip Code: 6";L— Fa _ f " Phone No. E -Mail: State or County License: If value of construction is $2500or more, a RECORDED Notice of Commencement is required. Lu oinair I certify that no work or installation has commenced prior to the�issuance of a permit to do the work and installation as indicatarl permit which is ina ntfli atn th any representation Association nting a ir will bylaws ear andpcovenants that build ay restrict o�rr prohibit structure 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, wails, 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 commencing work or recording our Notice of Commencemimnt Signature of owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF LI '. The forgoing instr me t was acknowledged before me this 12 day o� 20_1b by Name of p rson making statement Personally Known OR Produced Identification Type of Identification Produced DONNA M. HILL MY COMMISSION # GG 099038 EXPIRES: April 30, 2021 (Signature of Notary P Iatary '. is n erx e Commission No. (Seal) REVIEWS CO ONTER I RONIN SUP REVIEW ERVISOR RECEIVED DATE COMPLETED Rev. $/2/17 I5 '0 _7 Signature of Contractor/License Hol er STATE OF FLORI COUNTY OF The forgoing instr xient as ac cnowledged before me this 7tday of 20JA by Ct Name of per o aking statement Personally Known OR Produced Identification Type of ldentifica ion Produced DONNA At NILE. My CuVWSSION # GG 099038 j� of F'oPa EXPIRES:.Aprii 30, 2021 r 10r (Signature of Notary Pu ic- a df Commission No. (Seal) PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW AMR S www.aftridirectnry, org Certificateof ProductRatinas AHRI Certified Reference Number: 10525818 Date: 09-27-2018 Model Status : Active AHRI Type: RCU-A-CS Series: MOMENTUM Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : AL21 B4821 Indoor Unit Model Number (Evaporator and/or Air Handler) : AVV49DE321+CC Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, (L, 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 (95F), btuh : 45500 SEER: 20.00 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 madels 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. Ratio s that are accom anied by WAS indicate an involunta re -rate. The new published ratina is shown alcnp 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, personal and confidential reference. AM CERTIFICATE VERIFICATION AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ah ridirectory.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. d2018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE N[)_' 131825274824826192