HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q ---q-19
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Planning and Development Services
Building and Code Re.gWation Divicion
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
Permit Number:
Building Permit Application
Commercial Residential N _
PERMIT TYPE: 11" 1 , . I
Cr, , �'al
PROPOSED IMPROVEMENT LOCATION:
Address: - %oi C )caia ke_
Property Tax ID #: 13 b " 2 1U - C)C)±55" o0c __7 Lot No.
Site Plan Name:
Project Name:
Block No.
DETAILED DESCRIPTION OF WORK: i
CONSTRUCTION =NF(DRMATlON:
Additional work to be performed under this permit— check all that apply:
—Mechanical _ Gas 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: $ 3 _C:w Utilities: _ Sewer _ Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name i✓ciu5ar7f �th�j�l
�Iiiiiarn l-+. tSr�ifiDn .1,
Name: i
Address: -11o01 Cira ri kf- I
Company: 'R1ddvS
City: etf-1—ptfrCt- State: ti=t �
Address: '18I5 U.) Ar1'1Q1!° Rd
Zip Code: Etta I Fax:
City: date: �!
v L•
Phone No. -1-7 IL -sag- 5435
! Zip Code: 3i�`? Fax:
E-mail:
Phone No —7 -741L- 4W - 41,34
Fill in fee simple Title Holder on next gage (if different
E-mail bt.tdJus calci � gMa, • Co rn
from the owner listed above)
State or County License CPV I Salop la 3
1f value of construction is 52500 or More, a KtC.UKMLJ NOXICx or %.0m1F"rn4Lr11ic11a cs 1 "Ull r -
Ifvalue of HVAC is $7;5W or more. a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable I MORTGAGE COMPANY:
Name:_
Address:
City/-
Zip:
itT'Zip:
Phon
FEE SIMPLE TITLE HOLDER:
klnma-
Address:
City:
Zip: Phone:_
State
Not Applicable
Name:
Address:
City:
Zip: Phone:.
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip: _
Phone:
IOWNNIER/ rnnlTDArTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
v �n�n � Wv 1,1ra... rr••�
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
ARNING TO OWNER: YOUR FAILURE TO RECORD A RiaTI X O: : OMY.E,L'CEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB S17E 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 i Signature of Contractor/Lice se Hoiden
I STATE OF FLORIDA STATE OF FLORIDA ((yy
fL 1 1 i wi.� i �r \�i (_ l 1 (i t
j COUNTY OF Vit. �l,iCi+✓ COUNri yr • ^ �--
i
The forgoing instrument was acknowledged before me I The %going instr ent was acknowledged before me
�0 ( by this � day of 20� by
this � day of � — - --�
Y ft► on
Name of person making statement.
Name of person making statement. c
i
Personal, Known V OR Produced Identification
Personally Known V OR Produced Identification NIA.— y
Type of identification, Tvoe of Identification,
i Produced, N 11
ature ar Notary c�..c Stn of Ro iia R. Parsons
ignature of Notary Public- State or Florida I , ' 2A� r NOTARY PUBLIC
y A Kristina R. Parson
Commission No(�Goclol 31V Q� NOTARY PUBLIC, Commission No.( of gwwn# F OW838FLORIDA
STATE OF FLORIDA Cortur[G 23120216
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i `si 1 2(?2 i
REVIEWS FRONT I ZONA 7 S di PLANS VEGETATION SEREV REVIEW REVIEW MREVIEWVE j
COUNTER j REVIEW REViEtA! REVIEW REVIEW 1 I
DATE
rEI/ED
PLETED
�� L f Kod V 1 PlOdU%,,,L alai l� o
AHRI Certified Reference Number: 201785798 Date : 09-09-2019 Model Status: Active
AHRI Type: RCU-A-CB
Series: GSX16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX16S301A`
Indoor Unit Model Number (Evaporator and/or Air Handier) : ASPT37C14A`
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.
1A IN, KS MA, AAF MI. MN. AAO, MT, ND, NE, NH, NJ, NY, OH. OR. PA; RI; SD. UT, VT. WA, WV. W1. WY, U.S.
Territories)
Region Note : Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed in all regions
until J! ine 30, 2016. Beginninn 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 ANSVAHRi 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 : 28000
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 producedProduction Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
:
selling or offenng for sale.
Ratings that are accompanied by WAS indicate an invoiuntary re -rate The new published rating is shown abno with the previous (i.e. 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 atwww.ahrid I reeTory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual. pefsomai and
confidential reference purposes. The contents of this Certificate may not. in whole or in part. be reproduced: copied: disseminated:
A-1 M
entered into a cuntputer database; c;, othen ise utilized. in any font'' or manner or by anv means. except for the user's individual.
AlR-Co-NbtFt0NInG. iIE W`i'g.
personal and confidential reference. rccn{, ERAT!pN !NSTlTvTE
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at —w-hridirectory.org. dick on 'verify Certificate' link
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. 132125478217757662
v2uiy�`+iP-� VIIU;ijViij"g, ueand ft
3.j"MnPfYviatlprt iBSt( t)tl' CERTIFICATE NO.: