HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
CaU NT -Y
r E o R 1 o a
Permit Number:
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 arrow at the end of line
PRP-PO$E WPROVEME;111T LOCATION:
Address 1" u vn be; qc-�
Legal Description: SGz,r �, - %��afT a - L / Lo4
Property Tax ID #:-
Site Plan Name:CLVCnlI�,�
Project Name: j?cr1-A,,�
Setbacks Front Back: Right Side; Left Side:
DETAILED DESCRIPTION OF WORK:
A- , 0,,hCn)t C CAA L4 -e
Lot No.
Block No. / O
C 1, It -p- , 3 -TCS I I (.,e -<-,fF{e- , prn L -4_ Y) f4-,
CONSTRUCTION-.11\1iFORMATION:
j toona wor ,to e e orme under this permct - c
11 1HVAC 0 Gas Tank FGas Piping
1-1 Electric Q Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Na
a appy:
_ Shutters O Windows/Doors
EGenerator 0- Roof Roof pitch
SFt. of First Floor:
Utilities:] Sewer 05eptic Building Height:
City: State:kl�
Zip Cade: _�j a-- Fax: /U
Phone No Q�,—
E-Mail: A ) I a—
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:.
Company: r,
Address:
City: e/c C State: rc
Zip Code: -V_Cft - Fax �a - (, q4t
Phone No.
E -Mail:
State or County License:
If value of construction is $250(3 or more, a RECORDED M1lotice of Commencement is retiuired.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
nufwlrn 104. &S�m ...
(Seal)
%d VV 1rLn1 %-VIM 1 KAI.I un HrrIUV11 : 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, 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF�%A_4(
The forgoing instrument was acknowledged before me
this A day ofe 20 1g by
Name of per� �a n@king statement M:1k. Personally Known /� OR Produced IdentificType of Identification
Produced
(Signature of
Commission No (seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
5'�G 7 fi,/x�
Signature of Contractor/License H r
STATE OF FLORID
COUNTY OF )
The forgoing instrument was acknowledged before me
this �21 day of Kxp4ernb12!�: 20_M by
Name of pe on making statement
i A }
Personally Known OR Produced Identificatio
7 °
Type of Identification
Produced
a rs o
A
_Ln
in nm
(Signature of Notary KLbr
� cy m cr
��/�
Commission NohLC&�
w m n
(Seal)
w
N ffl bn
N
SUPERVISOR IPIANS I VEGETATION I SEEVIEWLE I MANGROVE
REVIEW REVIEW 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: 9115229 Date: 11-29-2018 Model Status : Active
AHRI Type: SP -A
Series: LX SERIES
Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING
Outdoor Unit Model Number (Condenser or Single Package) : PCE6B36'
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, ]A, 1N, KS, KY, L4, 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 (9517), btuh : 36000
SEER: 16.00
EER (A2) - Single or High Stage (95F) : 12.50
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 those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering For sale.
Ratings that are accom anied by WAS indicate an'involunta re -rate. The new ublished ratn is shown aion with the previous i.e. WAS ratan
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; AM
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 forthe model cited on this certificate can be verified at www.ah rid irectory.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.
U2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13137$841)543489581