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
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
qfi:
SX,
Address: i
re
A
Legal Description: &-K. !�_s Ito T
-T- G -
1
P ro pe rty Ta x 11 #: -3 0 0-, Lot No.
Site Plan Name:
Project Name-,
Setbacks Front Back. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
4<L00 �e' k�A r I C h -e
Block No.
Additional work to be ertormed under this permit— check all apply:
LNHVAC Gas Tank Gas Piping Shutters Windows/Doors
13 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction:
C"10,
$
Sc,. Ft. of First Floor:
Utilities: Sewer _ Septic
Building Height:
OWNER/LEE:
ESISl
CONTR ACTOR-
Name Yo rC�Lffl vi '7
Name: k" f)4 cr
Address.- f-0 C'7) (?z� ";l
Company:
City: StatO-&
Address:532- 11
Zip Code: Fax:
City:L4 L4,� luc State:
ec-)
Phone No.
Zip Code: 3qq�G Fax:_77)--`18q -3!S I I
E -Mail:
Phone No. '7 1
fill in fee simple Title Holder on next page if different
E -Mail: it -40.
from the Owner listed above)
State or County License-,
If value of construction is $2500 or more., a RECORDED Notice of Commencement is required.
"IT- I
SUPPLEFM COWSI)TRU'�'...'.,11 LIEN, LAW INFORMAT
DEI GNERANGINEER:
Name:Name:
Not Applicable
MORTGAGE COMPANY:
Address:
Not Applicable
_
Address:---,,,
City:
Z 0 ip* P h o n a-3
State:
�a_
City:
Zip: Phone.,
�._
FEE Vhv'�PLE TITLE HOILD F�E�Roo
Name.
Not Applicable
BONDING COMPANY:
Name:
Address:
)7J,
—Not AppiHcaWe
Address,-
City:
Zip: Phone:
City:
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 Countr makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con l,ct 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-residentiai 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
commencin.g w&A or recordinm jq
g_�Lour Notice of Commence e
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this k-- day of 20 j by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
QQ�My
,(Signature of l`e6_t1'ary -Public- State of Florida
Whole Daniel
V C9Oe4'96
MV jej�O�Dj�F
ism &%-""
Signaturi/of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this
of 20"1 by
Name of person making statement
Personally Known — X OR Produced Identification
Type of Identification
Produced
IN
QZ
(Signature of Notary PubWc"4�' State of Florida
CoMmIls
N10tVy putoe SUM of Fra
Michelle Daniel
F My CommissionFF906496
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FRONT 7' 16MM G I SUPERVISOR I PLAN r r'7CG'ET"A_T'I0_ N SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
AHRI Certified Reference Number: 201384201 Date: 02-12-2019 Model Status: Active
Old AFRI Reference Number: 8242076
AHRI Type: RCU-A-CB
Series: GSX16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package): GSX1 60241 F*
Indoor Unit Model Number (Evaporator and/or Air Handler): ASPT29B14A*
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, H1, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS,
MT, NC, ND, NE, INH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, Wl, WY, U.S.
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 GOODMAN 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 I 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 : 23600
SEER, 16.00
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.
ffigt_are accoMDanied by WAS indicate an involuntary re -rate. The new published rating is shown along with thePrevious rats Z
=""'7PMrS'E
ME" L,�=,2=.Z WAS
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
TERMS AND CONDI TROHNS
This Certificate and its contents are propHetary 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 Utflized, 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 wick on"Vor ify Cort If I *at es" Un k wo 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. 131944688349223854
@2019Air-Conditioning, Heating,and F ef Ngerat�on dnsUtute CERTIFICATE NO.: