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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO }MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _ i — Permit Number: J } wilding Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 452-1553 Fax: (772) 452-lS78 Commercial Residential PERMITTYPE: PROPOSEDIM Address: EMENT LOCATION: (-,AizLTtA Property Tax ID #: 112 1 .3 ' 009L 0 ✓ Lot No. Site Plan Name: .K OA) 0RUk Block No. Project Name: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: ;Mechanical —Gas Tank _Gas Piping — ShuttersWindows/Doors Electric _ Plumbing —Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Generator Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: AL ` !%/. Add re i� f Company: �•, tl :€.'f City: State: Address I' %.; _ V' City: 1�/ State: Zip Code: -_� (1 Fax: _ Phone No. /.�! q�q , /�� _ Zip Code: Fax: / E-Mail: — Phone Nod 1F� Fill in fee simple Title Holder on next page ( if different E-Mail ,&_11e5E���"7" State or County Licensed lf_ from the Owner fisted above) If value of construction is.7500 or more, a KEWHUtu Notice or i-ommencemeni Es requiceu. 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: I Zip: Phone: ["9\RlfllC� f e^elnorn n rw- �-w lv .tif 4v1v ! rUAL-I UK At-MUVII I : 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. thichis inocontlict with anyapplicab€e€Home O€wners Asssoc€ationipermit will es,abylaws or and covenants holder to maydrestrictbo prohib€t 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 FINAN NG, CONSULT WITH YOUR LENDS¢ P# AN ATTORIVF,Y BEFORE RECORDING YOUR NOTICE ❑F1rnmmr-iurrMF1u,W=1/ Signature of STATE OF FLORIDA COUNTY OF r as Agent for Owner � Signature of tontractor/LicensZ.H The for ping instrume t was acknowledged before me this day of € C-� 20/'�' by Atyy Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced 7 e,, ( RIS WOQDBERRY of Commission No. (Seal) REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED STATE OF FLORIDA COUNTY OF ,c The forgoing instrument was acknowledge before me this day of 20 by 14 Name of person making statement_ Personally Known OR Produced Identification Type of Identification Produced (S Cam (Seal) SUPERVISOR I PLANS I VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW ti91 CERTIFIED° wwtiv.ahridirectpry.org Certificate of Product Rati!jgs AHRI Certified Reference Number: 201907209 Date: 08-12-2019 Model Status : Active AHRI Type i RCU-A-CB Series: DAVE LENNOX SIGNATURE XC21 SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : XC21-036-230-10 Indoor Unit Model Number (Evaporator and/or Air Handler) : CBA38MV-036-230"+TDR 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, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, VW, 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 LENNOX 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 (95F), btuh : 35600 SEER: 19.00 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. Ratinos that are accompanied by WAS indicate an involuntaU re rate. The new published ratin is shown along with the previous i.e. WAS rafin . 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, disclaims liability for damages of any kind arising out of the use or performance of the product(s), or the the product(s) listed on this Certificate. AHRI expressly all 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, personas and in he reproduced; copied; disseminated; an confidential reference purposes. The contents of this Certificate may not, in whole or part, entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahrldlrectory.org, click on "Verify Certificate" link issued, we make life hatter and enter the AHRI Certified Reference Number and the date on which the certificate was which is listed above, and the Certificate No., which is listed at bottom right. CERTIFICATE 132100832059 751 ©2019Air-Conditioning, Heating, and Refrigeration Institute NO.: