HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number:
= RECEIVE
Building Permit Application ��jg
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Planning.and DevelopmentServices
Building and Code Regulation Division
23t1Q rginiaAvenue Fort Pierce FL 34982 ng Departm Int
Phone:(772)462-1553- Fax:(772)462-1578 Commerci ,I ' Reie County►
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PERMIT APPLICATION FOR: To Select from dropbox, lick arrow at the-end of line
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Address: 113()3
Legal Description: T`C Q_ I, R . 3 6—SOQ 7o�
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PropertyTax ID#: NNW"��.,��"1��C7� C)C7C�—o( �, _ Lot Na.
Site Plan Name: Block No.
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Project-Name: d a r (ad
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Setbacks Front ! Back: Right Side: i^Left Side:
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Acamonal wor, o.1 e e rrormed I un er is permit—check all that appy:
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HVAC i Gas Tank oGas Piping �` Shutters Q Windows/Doors
�Electric' (�Plumbing ❑Sprinklers E, Generator Q Roof C� Roof pitch
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Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 535S. 00 Utilities: I` Sewer[]Septic Building Height:
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Address-VOL41q N1,10 AIA U 303 Company: Ud A
city.-IL Pi r` Q� State:F- Ado�}i ress:)401 P ar Ir-kV 0 � A
Zip Code: 'ACIti4 Q Fax: City! ozcl)O,_ State:
Phone No. I A LD7 _Q a a 1 Zip ode: �o
E-Mail, t Ph ne No. 31—M—Mr-4 t'9
Fill in.fee simpie Title Holder on next page(if different E ail:
from the Owner listed above) sta a or Coun y license. t I LA L�LA t
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if value of construction is$2540 or,more,a RECORDED Notice of,Comrr encement is required.
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DESIGNER/ENGINEER: _Not ApplicableMORTGAGE COMPANY: _Not Applicable
Name: Nam1 :i
Address: I Address:
City: I State: City , State:
Zip: Phone zip:." Phone:
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FEE SIMPLE TITLE?HOLDER: _Not Applicable BON PING COMPANY: _Not Applicable
Name-
Name:
Address: Address:
City: I City:
Zip: 'Phone: Zip: I! Phone:
OWNER/CONTRACTOR AFFID.VIT: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 issuancd of a permit.
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St.Lucie County makei,no representation that is granting a permit will a thorize the permit holder to build the subject structure
which is in conflict with anyappli,cable Home Owners.Association rules;b�laws or and.covenants that may restrict prohibit such
structure.Please consult with your Home Owners Association and revieu�.your deed for any restrictions which may apply..
In consideration of the+granting of this requested permit,I do hereby agre that I will,in all respects,perform the work
In accordance with thelapproved plans,the Florida Building Codes and St;Lucie County Amendments.
The following building permit applications are exempt from undergoing a#ifull 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 ComTepcement may result in your paying twice for
improvements to your property.A Notice of Commencemen I must be recorded and posted on the jobsite
before the first inspection.`If you intend to.obtain financing, onsult with lender or an attorney before
cornmencin work or recording our Notice of Corr:men cemdhf.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
1.
STATE OF FLORIDA STATE OF FLORIDA
.
COUNTY OF COUNTY OF
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The forgoing instrument was acknowledged.before me The f�,�r�,oing Instrument was acknowledged efore me
this_day of I 20_ by this'day of 0 `Wbe f 20��by
Adrw Procell
Name of person making statement ,' ;Name of person making statement
Personally Known i OR Produced Identification Personally Known OR Produced Identification
Type of Identification; Type of Identification
Produced Produced
(Signature of Notary Ilublic-State of Florida) ( ign ture of-Notary Public-State of Florida)
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TRAVIS BATC iE ER
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Commission No. (Seal) Commission No. �Fgg2�02- NOTARYPUBL
STATE OF FL A
); Cornm4€FF9M
'✓mires 5116i n
REVIEWS FRONT ZONING SUPERVISOR PLA 5 VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEkt REVIEW REVIEW REVIEW
DATE i
RECEIVED
DATE
COMPLETED
Rev.8/2/17'
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Ce-nifitcate of Produ ` t Ratings
AHRI Certified Reference Number.3550708 Date:10.31-2018 Model Status:Active
-Old AHRI Reference';Number
Product :Water-to,'Air and brine-to-Air
Model Number,W6VC030*-2
Manufacturer Name; :FIRST CO:
Brand Name, :HYDROTECH
Rated as foliows,inaccordance with.ANSt1AHRI/ASHARE/ISO Standard 13258-1 Water-toAir and Brine-To-Air Heat Pumps and subject to
,verification of rating accuracy'by AHRI-sponsored,independent third warty testing:
Full Load Part L rad1 Part Load2 Part Load3
Air Flow Rate-Cooling: 930
Air Flow Rate-Heating: 930
s
WLHP(Water-LoopFHeat Pumps)
Cooling Capacity(Btuh) 27800
Cooling EER Rating;(Btuh/watt) 13.00 ,
Cooling Fluid-Flow Rate(gpm) 7.50
Heating Capaelty(B61nh 33900
Heating Copy{watUwatt)
Heating Fluidflow Rate(gpm} 7.54
GWHP(Ground Water-Heat-Pumpsj "" ;r
Coofng Capacity{i3fuh} ? 34004
18:00
Cooling EER Rating(Btutl/Watt),. `
Cooling Ftuid.Flow:Rate(gpm)-N ` 7:50
Heating Capacity(Bich) 26900 -1 I W t C
Heating COR`(watt/watt) ;'_ _` r_ 3:80
heating Fluid Flow ata{gpm) .; 7 50 # )
GLH?(Ground"-Lbbp Heat Pumps) ?s
Cooling Gapacit,(bi6h)
Goofing EER Rattng`(B{uh/VYatt}' 4
600Iing,F161d.Flow..RiIte=(gpm)
-Heating -l -
Capacity{Btiifii)
Heating COP(watttwatt)
Heating Fluid Flow Rate(gpm)
i
Indoor Blower Motor Fan Type :PSC
Sold In? :USA
t'Active'Model Status are those that an AHRI Cerlificallon Program Participant Is currently producing AND,selling or offering for sate:OR new models that are being
marketed but ale 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. Ii
Ratings th t are ac pled by WAS Indicate an in I nta re-rate. The new 2&ihed rating s Ehown along with the vi us i.e.WAS ratin .
DISCLAIMER
AHRI does not endorse the product(s)fisted on this Certificate and makes no repres'ntations,warranties or guarantees as to,and assumes no responsibility for,
the product(s)listed on=this.Certificate.AHRtexpressly disalairs all liability for da 's of any kind arising out of the use or performance of the product(s),or the
unauthorized alteratlon of data fisted on this Certificate.Certified ratings are valid okty for models and configurations listed In the
directory at www.ahrid�ireetory.org. I'
TERMS`AND CONDITIONS '
This CeMcate and fts.eontents 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;
As
entered into a computer database;or otherwise utilized,in any form or manner or b?y any means,except for the user's frufividuat,
personal and confidential reference. ti AIR-CONDITIONING,HEATING,
CERTIFICATE VEItiFICATION &REFRIGERATION INSTITUTE
The information for An model cited on this certificate can be verified at www.ahfI4itect0ty.0r9,crick on'Verify Certificate"link r fn 6y Ei; ;e;ces
and enter the AHRI Cohified Reference Number and the date on which thecertifica' was issued,
x "' E NO.. 131854647085649211
which is listed above,and the Certificate No,which.is listed at bottom right
02018Aif°-Conditioning,Heating,and Refrigeration Institute 1-)65 RTi01W
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