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HomeMy WebLinkAboutbuilding PermitALL APPL C BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'ti �Z� Permit umber:
_ §II
W501* 119 1 pt
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 _
PERMIT APPLICATION FOR: To Select from dropbox, click arro at the end of line
PROPOSED IMPROVEMENT LOCATION zr, *{
Address: i0 �) Cvlu
Legal Description:
X
Property Tax ID #: �� 2� �V�j �-- - L
Lot No.
Site Plan Name:
Block No.
Name:
Project Name:
City: T !CC -t'- State: _
Zip Code: Fax:
jj ��, q
Phone NO. " Z ' i(-
Setbacks Front Back: Right Side:
Left Side:
City:' x � i �-
Zi P Code: � 'G.
Phone No.
Fax1 1Z"���i3
DETAILED DESCRIPTION OF WORK
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: lL_
State or Coun y License: ILN _-A
1�t V'_Y `I "CXD�
.:
COIVSTRUCTiON"`INFORMAT[ON ;°=
.__.
Additionalwork to be clertormed uncTerthis permit- c ec
a app y:
Q
®HVAC Gas Tank ]Gas Piping
_Shutter
Windows/Doors
11 Electric ❑ Plumbing Sprinklers
ElGenera or
E]Roof Roof pitch
Total Sq. Ft of Construction:
G
S. Ft. of First Floor:
�\
Cost of Construction: $J Utilities:
_ Sewer _Septic
Building Height:
OWNER/LESSEE:CONTRACTOR:
_'
Name GLC 0 M
Address:
Name:
Company:
City: T !CC -t'- State: _
Zip Code: Fax:
jj ��, q
Phone NO. " Z ' i(-
AddKs
City:' x � i �-
Zi P Code: � 'G.
Phone No.
Fax1 1Z"���i3
State:
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: lL_
State or Coun y License: ILN _-A
It value of construction Is )z5Uu or more, a KtLUKUtU IYDUCe UI WI I] H Mn l.en III n LIZ Ic4u -
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
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 per itto 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, 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 ecorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult wi In lender or an attorney before
rnmmanrina %ninrk nr rornrrlina vniir Nntira of CnmmPnrement.
Signature of Own r/ essee/Contractor as Agent for Owner
Signature of o actor/License Holder
STATE OF FLORI AC"
STATE OF FLO 1IDA
COUNTY OFA C,;-)
COUNTY OF
The forgoing instrument was acknowledged before me
The for oing Inst ument was acknowledged before me
day eez_ 20 ic; by
this day of �`�'2 20 iF) by
this of IV
c rc�ll�
' c; c (C(f7)
Name of pers n making statement
Name o person making statement
Identification
Personally Known OR Produced Identification
Personally Known OR Produced
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- St} .Flor
, 6tjherine Konger
(Signa ure of Notary Public- State q# Florida )
Catherine
Commission No �2 "E � bn#FF172372
Rs: OCT 28, 2018
titer► Konger
Commission No. 1�'� ,bion#FF172372
BONDED
�y a�=Expires: OCT 28, 2018
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THRU
1ST FLORIDA NOTARx LLC
,OF c3�' BONDED THRU
nu„ IST FLORIDA NOTARX LLC
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
AHRI Certified Reference Number: 3383109 Date : 11-12-2018
Old AHRI Reference Number :
Model Status: Discontinued
Product : Water -to -Air and Brine -to -Air
Model Number : TCH/V036AG
Manufacturer Name : CLIMATE MASTER, INC.
Brand Name : TRANQUILITY 16
Rated as follows in accordance with ANSI/AHRI/ASHARE/ISO Standard 13256-1 Water-toAir and Brine -To -Air Heat Pumps and subject to
verification of rating accuracy by AHRI-sponsored, independent third party testing:
Air Flow Rate - Cooling:
Air Flow Rate - Heating:
WLHP (Water -Loop Heat Pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuh/watt)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating Cop (watt/watt)
Heating Fluid Flow Rate (gpm)
GWHP (Ground Water -Heat Pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuh/Watt)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating COP (watt/watt)
Heating Fluid Flow Rate (gpm)
GLHP (Ground -Loop Heat Pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuh/Watt)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating COP (watt/watt)
Heating Fluid Flow Rate (gpm)
Indoor Blower Motor Fan Type
Sold In? : USA
Full Load Part Loadi Part Load2 Part Load3
1150
1150
34500
13.50
9.50
45200
4.40
9.50
38700
20.70
9.50
37500
4.00
9.50
35300
14.90
9.50
29600
3.30
9.50
tModels with "Discontinued" Model Status are those that an AHRI Certification Program Participant no longer
AND is no longer selling or offering for sale.
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. 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 r:e make life tetter'"
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. -
131865171044341634
©2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: