HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BECOMPLETEDFOR APPLICATION TO BE ACCEPTED
Date: _,t1 ` L 1 CI Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address:
i
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
L
E CL A,
CONSTRUCTION INFORMATION:
Acfditio 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: $ _ Q Utilities. _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTR CTOR:
Name L Name:
Addre5s:1 A�'�- Company: -
_
City: _V �t_11 _ State: ddress:
Zip Code: ��� 1 JC6� Fax: City: St te:
Phone No. qk L-\- ,h 3jO 7 Zip Coder
E-Mail: Phone No -
Fill in fee simple Title Holder on next page ( if different E-Mail O.
from the Owner listed above) State or County License
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.
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 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 YOUR LEND OR N ATTORNEY BEFORE RECORDING YOUR NOTIC F CO MENCEMENT."
Signa ure of Contra r se Holder
Si of caner/ ssee ntractor as Agent for Owner
STATE OF FLORIDA J
STATE OF FLORID \�
'^` �\
COUNTY OF ' ` �.L�\
COUNTY OF V V
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type f Identification
Produled
Type of identification
Produce
� l
Signature of Notary Public ta�q�FloLState of Florida
/ �P .•� ercado
Commission No. a "012021 t�t,i
ignature of Notary Publ' Sit f Flm�* wait State of Florida
Wanda E Mercado
mmission No. Ey�p� 136116
Ex 21
REVIEWS
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ZONING
SUPERVISOR
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SEA TURTLE MANGROVE
COUNTER
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DATE
COMPLETED
ev. 2/7119
Certificate of Product Ratings
AHRI Certified Reference Number: 201417943 Date: 10-17-2019 Model Status: Active
Old AHRI Reference Number: 8655532
AHRI Type: RCU-A-CB
Series: GSX14
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSxl40241 L"
Indoor Unit Model Number (Evaporator and/or Air Handler) : ARUF29B14A'
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, NO, NE, NH, NJ, NY, OH, OR, PA, Ri, SO, UT, Vr, 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 ANSIlAHRI 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 : 23600
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.50
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 s or offering for sale.
Ratinor.
that are accompanied by WAS indicate an involuntary re -rate. The new published Latin is shown alon with the previous fe. WAS rati
no
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 products) 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.ahrid!rectory.o►g.
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,
Arm
personal and confidential reference. AIR-CONDMONIN0, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.a hridirectory, 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.
02019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132158080758581648