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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ./ Date: ! / s Permit Number: w Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1SS3 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED,IMPROVEMENT LOCATION: "5Co0_-, � 1 / r rf �, Address: L [ C l�r-.� ..� �r -, Legal Descriptio i7 ii,- Property Tax ID #: C bb g — o g _ Wo wC2 Lot No. Site Plan Na e4- Block No. Project Name: �L; n Setbacks Front Back: Right Side: Left Side: DESCRIPTION OF WORK: /DE.TAILED r`�'1 � � � rl [�...Q. C��-1.� �(� ��f C7 � � ! � . � � v � 1 � lL ��'��" J C, n►- �4 C3I�, C-- )c (,A -D -e CONSTRUCTION INFORMATION: AaClitional work to DEIrrormea under this permit- cnecK HVAC — Gas Tank DGas Piping OElectric Q Plumbing Sprinklers all mat apply: _ Shutters 0 Windows/Doors E Generator 0 Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ o Utilities: "Sewer 0 Septic Building Height: Height- ©W N EIS/LESSEE: CONT.,. Name_ Namer TL L Address: ,� Company: City: i�f±0,2rG.e. _ State: Zip Code: 3 4 Fax: IJ Phone No. __NAA Address:, City:,/ c,c State: +– Zip Code: Fax: Phone No. ''7;;1 --to _ E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail; A i State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: state: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Nat Applicable BONDING COMPANY: Not Applicable Name: 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 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, l 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 attornev befnrQ commencing work or recording your Notice of Commenceme Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORID COUNTY OF The forgoing instrument was acknowledged before me this I day of ,,, 2016 by Name of person making statement Personally Known OR Produced Identification Type of Identification Produced (Signature of N ary Ic- Florida ) Commission No&e— 2&3;Z3q (Seal) JENNIFER E. CAGAS REVIEWS 1 FRO N O1`91AlIa.i a No IP6AV2 RECEIVED DATE COMPLETED Rev. 8/2/17 17 Signature of Contractor/License Halder STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this I day of Nooern� 20J& by Name of person making statement Personally Known ?� OR Produced Identification Type of Identification Produced _ {Signature of ar orida ) Commission Nohe'zb "'*% JENNIFER E. CAGAS '� "" C mr^ission No. PLANS VEGETATION S ��'N1l l FCa mipr t, REVIEW I REVIEW •+�:©1 CERTIFIED° www.ahridirectnry, orgcertificate of Product Ratinas AHRI Certified Reference Number: 9950155 Date : 11-01-2018 Model Status : Active AHRI Type: HSP -A Series: LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : PHE61336 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 ofANSIIAHRI 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 : 36400 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 12.50 Heating Capacity (1-112) - Single or High Stage (47F) : 33800 HSPF (Region IV) : 8.20 t"Aclive" Model Status are those that an AHRI Certification Program Participant is currently preducfng AND selfing or offerfng 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 that are accom anied by WAS indicate an lnvolunta re -rate. The new published ravu is shown along with the Drevicus Q.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 anly 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. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the 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. 02018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO_' 131855467771624314