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HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:,) f Permit Number: MW Building Permit Application Planning and De velopmen t Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Address Property Tax ID #: Site Plan Name: # Project Name: ,")a ". 10 1 r— L0 Hec 4— � /! 7 5&C-4 , L/TbwJ j CONSTRUCTION INFORMATION: Lot No. % a - Block No. 9 Additional work to be performed under this permit –check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors w Electric Plumbing _ Sprinklers _ Generator ` Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ . L,%LYX Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name -Sc s,nj_ KLm&A a M cii, leer - Name S rrnUe ) ; heC'n Address: Lr3� 1�'���t ? Company:.Adi1 ccr City- State: E: Lam"e Address:1 rT-tU'� Zip Code: ` Fax: �_J j> City: 4;4- f /el-ce _ State: ''�L Phone No, 1U Ifs s Zip Code: Sq9g�� Fax: 5= fl y E -Mail: YJ 1+ Phone No7Y9-- (yJ�`–,/ aw Fill in fee simple Title Holder on next page ( if different E -Mail from the Owner listed above) State or County License &61 11 value or consiruciion Is �PGSuu or more, a KLLUKULD Notice of Commencement is required. If value of HVAC is $7,500 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: 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: 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, I do hereby agree that I will, in ail 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License H der STATE OF FLORID STATE OF FLORIDA COUNTY OF ( COUNTY OF L( The forgoing instr ent was acknowledged before me this ) day of 2011 by Name of person making statement. Personally Known XOR Produced Identification Type of identification Produced (Signature of Notak5 �aj-- Commission No ' - P3C (Seal) The fooing instr rgent wa acknowledged before me this l day of G A 20-ff by Name of person making statement. Personally Know OR Produced Identification Type of Identification Produced (Signature of Notary Commission No.&62' .3A3 (Seal) REVIEWS FRONT ZONING SUPERVISORPLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE JENNIFER E. CAGAS Notary Public, State of Florida Commission No. GG263239 Commission Exorac0913012022 ��� CERTIFIED° www.ahridireatory.orgCertificate of Product Ratinas AHRI Certified Reference Number: 8458527 Date : 03-01-2019 Model Status : Active AHRI Type: RCU-A-CB Series: LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC464821 Indoor Unit Model Number (Evaporator and/or Air Handler) : AE48CX21+TXV Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, 1N, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 ANSI/AHRI 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 : 47000 SEER: 15.75 EER (A2) - Single or High Stage (95F) : 12.75 f"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. Rat,M'S that are accompanied by WAS indicate an involuntary re -rate. The new Published rating is shown along with the Drevious (i.e. WAS) ratino. 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 ARM m 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 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. ©2019Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 131959264595071309