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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO IJE ACCEPTED ( l Date: r Per Number: 05� • 'ZOO, . _ � mer F,o Fp, Building Permit Application 'q;, Planning and Development Services �tiF�® 101,9 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 dya't Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: /4( 1 C_ PROPOSED IMPROVEMENT LOCATIO Address: 00-L C__r Property Tax ID#: �� J c� (p 000 1 ­00 Lot No. Site Plan Name: i Block No. Project Name: DETAILED DESCRIPTION'OF WORK: --cw .tel wl > cu�c�? �l� fEiss CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: mechanical _G.as Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ r3,Z) CD C�l Utilities: —Sewer' —Septic Building Height: OWNER/LESSEE: CONTRACTOR:' ; Name k )kr-%tN% Q nXd UQ Name:�d as c t j &A- ►SD Address:_ a0 0 L4 WU GC4Cw OA Company: 0_�nQXOSOI(, City: C­V Pie-('La State:EL Address: 1'/a p 0 l OSep �Up Zip Code: "Y. R A LQ Fax: City: PI,t r-a State: Phone No. Zip Code: 3 Fax: 77z--ba1 5)� E-Mail: Phone No "7�� L4ka - s) Z)A Fill in fee simple Title Holder on next page(if different E-Mail_ Q!gQ-Viie f 07� Cb f40%. CO•w, from the Owner listed above) State or County License �ftL gl LaS If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. I i 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 ipermit 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 thepermit holder to build the subject structur,l 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. I 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 I AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT " WIIJWYOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR TICE OF COMMENCEMENT." Signa re of Owner/Lessee/Contractor as Agent for Owner Signature loontractor/License Holder - ST TE OF FLORIDA STATE OF FLORID& COUNTY OF S� `�° COUNTY OF The fqr oing instrume t was acknowledged before me The fo going i,nstru ent was acknowledged before me this qday of 2076y this day'of20_C 'by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced -4124 (Sign (Signature oo N, u - E e $ N =* ■_ Commission #GG 270079 ;;os`YP�l% ,y a; 4� State of Florida-Notary Public M Commission Expir Com ssji� y , 2022 lea Commission g� *_ Commission #G(�$��jp79 Owtobfa, 272y Commission Expires October 22 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW !REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19 I Own NEILS CERTIFIED" r r r ke , Rating ACertificate ®f Pr®duct s .. AHRI Certified Reference Number:201785798 Date:,09-05-2019 Model Status:Active AHRI Type:RCU-A-CB Series:GSX16 Outdoor Unit Brand Name:GOODMAN RECEIVED Outdoor Unit Model Number (Condenser or Single Package):GSX16S301A' Indoor Unit Model Number(Evaporator and/or Air Handier):ASPT37C14A' SEP 0 6 2019 Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,p_%pWir0 agrTo A P,IL, IA,IN,KS,MA,ME,MI,MN,MO,MT,ND,NE,NH,NJ,NY,OH,OR,PA,RI,SD,UT,VT,-%A,,L 1/ ;(WI,,rWY,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. i 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:28000 SEER:16.00 EER(A2)-Single or High Stage(95F) :13.00. I I 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. previous(i.e.WAS)rating. Ratings that are for by WAS indicate an involuntary re-rate. The new published rafinq is shown along with 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 disclaims all liability for damages of any_kind arising out of the use or performance of the product(s),or the unauthorized alterationof data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridIrectory.org. I TERMS AND CONDITIONS Una 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.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 CERTIFICATE NO.: 13212190194439638 II i I r%m NOSS CERTIFIED www.ahridirectory.org LE IL certificate of Product Ratings AHRI Certified Reference Number:201785798 Date:09-05-2019 Model Status:Active I AHRI Type:RCU-A-CB RECEIVED Series:GSX16 SEP 0 6 2019 i Outdoor Unit Brand Name:GOODMAN Permitting Department Outdoor Unit Model Number (Condenser or Single Package):GSX16S301A* ! St. Lucia\.rr,,,,,r., i Indoor Unit Model Number(Evaporator and/or Air Handier):ASPT37C14A* II > 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) j 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. I � 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(9517),btuh:28000 i SEER:16.00 EER(A2y-Single or High Stage(95F) :13.00 i 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. Ratings that are accompanied by WAS indicate an invgluntary re-rate The new published ratina is shown alono with the Drevious fie WAS)rating 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.ahridfrectory.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, AM 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 CERTIFICATE NO.: 132121901394439638;