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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Is am 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: 4.Ujtn iti7 � r— PROPOSED INPROVEMENT LOCATION: Address: "A—J Legal Descri tion: IL 0 Y Property Tax ID #: a4H 57D � CO Lot No. Site Plan Name: Block No. ` Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: W 3 �C t CJ l�Q ✓L CONSTRUCTION INFORMATION: Additional work to be performed un ert is permit— check 0 that appy: -,/Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: aj� Cost of Construction: $ �� Utilities: —Sewer _Septic Building Height: OWNER/ ESSEE: CONTR CTOR: Name: I A.) `J C Addre : Company: City: State: Address: Ai Zip Code: Fax: City: State: Phone No. � is — Zip Code: Fax. ©I"16 E -Mail: Phone No. N_ Fill in fee simple Title Holder on next page ( if different E -Mail a tYJ( Q 14 C • C�+t�J from the Owner listed above) State or County License: If value of construction is 25nn - wmmencemenr is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: 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 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, 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 IDURTEN—DRE-0 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Holder STATE OF FLORID�^p' STATE OF FLORIWg, COUNTY OF .-JC/1V1� t_uL�` COUNTY OF JCLk Ir - The for oing instrument was acknowledged before me this 21 day of J_JAL 20 1 q by 1�11LilV'11 � l CCJJ.I.I_�� Name of person making statement. Personally Known _> OR Produced Identification Type of Identification Produced _kSignature of Notary Public- State Commission No. ol7UT The for oing instrument was acknowledged before me this j� day of T d A ' 20i -ft by �eA'1Y'l15 Ci��.�¢Skc` Name of person making statement. Personally Known X OR Produced Identification Type of Identification of Florida) (Signature of Notary Public- Statq gfflorida ) Stele of No. Public stele o/ REVIEWS FRONT ZdIQIl4tS��Stli�GQ�( r ,�P A VEGETATION SEAREVIEW E — REVIEW COUNTER REVIEW REVIEW 1 -RF REVIEW REVIEW REVIEW DATE RECEIVED GE4=141 ® www.ahridirectory.ory ProductCertificate of • tina AHRI Certified Reference Number: 202349756 Date: 07-01-2019 Model Status: Active AHRI Type: RCU-A-CB Series:GSX14 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX140361 K` Indoor Unit Model Number (Evaporator andfor Air Handler) : ASPT35B14A' 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, IN, 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 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 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 : 34000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 11.80 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 offedng 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 date 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.ahrid[rectory.org. click on -Verify Certificate' link and enterthe AHRI Certified Reference Number and the date on which the certificate was Issued, xr make life leeucr"' which Is listed above, and the Certificate No., which is listed at bottom right — ©2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132064611504554795