HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X,
Phone: (772) 462-1553 Fax-, (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
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Address: 1OL01
Ll
LAS',
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1 21) [,11' 4 i
Legal Descr*ption: I 4�, �'f' v cetl�
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Property TLot No.ax ID #:
Block No.
Project Name: Is
Setbacks Front Back.- — Right Side: Left Side:
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''DETAILED DESCRIPTION OF WORK:
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.CONSTRUCTION INFORMATION:
itional work to be ertormed under this permit – check :hat appy.
rVI
!&JMVAC Gas Tank Gas Piping Shutters windows/ Doors
11 Electric Plumbing Sprinklers Generator Roof I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ c&'
Sc:. Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
OWNER/LESSE E
CONTRACTOR:.
Name
Naive: k o4 cr
I f'o OXC"k
Address: M 1 61 V4
Company: ervic-e-, LLC'
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City.. State
Address: 5 a,(- cot) e" L � I
Zip Code: Ll C/
I 'Z Z"
Fax:k"PhoneNo.3q9g661
city: Por4 S�-��.State,
71'_)50 q&
Zip Code: Fax -.77:) Sq
E -Mail:
Phone No. '72z-- �n i __16W
fill in fee simple Title Holder on next page if different
E -Mail: (40 a
from the Owner listed above)
State or County License:. CACI I %i
It value of construction is 52500 or more,, a RECORDED Notice of Commencement is required.
_'U P L E. M E EN11 LAVN! INIFORN.,l
NTAL CONSTRLTTION ATIOINO
DESIGN E R/ENGI NEER:
Name:
Not Applicable
MORTGAGE COMPANY.
Name:
Address:
Not Appkabka_
Address:
City-O
Zip: Phone
St a te
City:
Zip: Phone:
SS, t a t e.,,
FEE SIMPLE TITLE HOLDER,
Name:
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Not Applicable
Address'.,
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 aP ermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Associat ion 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 w-oA or recording y r Notice of Commence a -,..
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF jo:� �.
The forgoing instrument was acknowledged before me
this I day of FCbtV 20147 by
Name of person making statement
Personally Known X OR Produced identification
Type of Identification
Produced
JSignature of 4�8tary Public- State of Florida
RM
Daniel
0�n FF 9,08496
Rev EW FRONT ZOT4 I N G
. I COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Si, natur of Contractor/Lirense Holder
STATE OF FLORIDA
COUNTY OF eo
The forgoing instrument was acknowledged before me
this day of
by
10
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pubrfc': State of Florida )
Comm I
NOtmy pwmw stme of FWWa al)
Michelle Daniel
My COMMiSSion FF 906496
SUPERVISREVIEWOR I REVIEW PLANS' VE�GPTWON
REVIRESEAVIEW TURTLE MREVIEWANGROVE
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 319 2016.
X All
As
.V
AHRI Certified Reference Number: 9993615 Date: 02-01-2019 Model Status : Active
AHRI Type: RCU-A-CB
Series: AVXC20
Outdoor Unit Brand Name: AMANA
Outdoor Unit Model Number (Condenser or Single Package): AV 0200361 A' --
Indoor Unit Model Number (Evaporator and/or Air Handier) -. A-\JIPEC59D14A*
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, 1KA10, NIS,
MT, NC, ND, NE, NH, NJ, NM, N1V, NY, OH, OKo OR, PA, R1, SC, SD, TN, TX, UT, VA, VT, VJA, WV, VVI, 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 AMANA product is responsible for the rating of this system combination.
Rated as -follows in accordance with the latest edition of ANSI/AHRI 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 : 33400
SEER: 21.00
EER (A2) - Single or High Stage (95F) : 13.00
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 those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
F�atings that are accom anied bv WAS indicate an invol i re -rate. Thnew au
&lished rgtines shown 19
.gwith the
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 discWhis 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 ihe
directory at
TERMS AND CONDITIONS
This Certificate and its contents are proprietary produlcis of AHRL This Certificate shall only be used for individual, personal and
confidential reference purposes. The contents of this C*evflf1cate rnay not, in whole or in part, be reproduced; copied; disseminated;
entered into a computer database; or otherwise utilized, in any form or mariner or by any means, except for the user's individual,
personal and confidential reference. AIR -CON DITIOMEN G, HEATING,
CERTIFICATE VERIFICATION &
The information for the model cited on this certificate can be verified at click on "Verify fl k
Nve naake life. getters"
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.
@2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131935114228033803