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Home My WebLink AboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: j _ Permit Number: IBM 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 xi PERMIT APPLICATION FOR: To select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: ( C) 1 rit_ C-,4- D Legal Description: c r `-ut r< i �- i f - IC 1 y� p dL-Cl�`1�P_ &3 �9 Property Tax ID##: I3(:>1 - (�(3-6��_p — Lot No_ Site Plan Name: Block No. Project Name: 1L Setbacks Front Back: Right Side: Left Side: t3 A11 If E SCRIP- 1014-0 -OR.K; 2 C)uk LL` �C _e_ r L.[` Cr.2 Q co 1 r? SECu2 , tTC,18,3(oa l , A-r--�aC' �� i +-Tk\l 0 Plumbing Sprinklers "Shutters OGenerator Windows/Doors Roof Total Sq. Ft of Construction:: S Ft. of First Floor: Cost of Construction: $ Utilites:Sewer Septic Building Height: Roof pitch 0 11�VLI~SSEE: C0NTRACTC3.R: Name v� Name: Address: �e arjc- Company: Address: b6{ rk e City: q -erc-e State -All Zip Code: 3 qQ$�9-_ Fax:�a6- V?g Phone No.77P-W' 5_- (o(X.a City; ti State: PC- Zip Fax: N 4 Zi Code: 3 �-{ �'(S1 Phone No. _ A.) IA- E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E -Mail: State or County License: 11 vaUC UL can axucuon IS ;�4.7UU or more, a KLLUKUtU Notice of Lommencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION; DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address; City: State: Zip: Rhone City: TState: Zip: Phone: FEE SIMPLE TITLE HOLDER.: Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR 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 issuance of a permit. St. Lucie Count 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 you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commenceme Signature of Owner/ Lessee/Co or as Agent for Owner STATE OF FLORIDA t COUNTY OF The for Ding ins wasacknowledged before me this day o men 20j& by Name of pemaking statement rso Personally Known OR Produced Identification Type of Identification Produced_ (Signature of Notary Public State of Florida ) Commission No. J.-`�,_ DONNA"LI _. MY COMMISSION # GG 099038 EXPIRES:Aprli 30, 2021 REVIEWS I FRONT I CO NTER ROEVI W I SUPERVISOR REVIEW RECEIVED DATE COMPLETED Rev. 8/2/17 Signature of Contractor/License Holder STATE OF FLORI COUNTY OF gLk(-' -Q— The forgoing ins ent wa acknowledged before me this�(Q day on 20J8 by Q. /Y1 V e I I . A_\,�m Name of person making statement T Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Commission No. PLANS I VEGETATION REVIEW REVIEW (SO04NA M. HILL MY COMMISSION # GG 099038 EXPIRES: April 30, 2021 SEA TURTLE I MANGROVE REVIEW 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: 8900649 Date: 09-26-2018 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) : TC7133621 Indoor Unit Model Number (Evaporator andior Air Handler) : AE42CX21+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 t, 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 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 (95F), btuh : 35400 SEER: 17.00 EER (A2) - Single or High Stage (95F) : 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 these that an AHRI Certification Program Participant is no longer producing BUT is still selling '"Tin for sale. Ratin s that are accom anied byWAS indicate an involuntary re rate. The new ublished ra5n is shown a n with the revious 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 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.ahFidiFeCtory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and 1101 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, Al 1111111111r% personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.abridirectory.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. 131824636735031367 02018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: