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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D Permit Number;
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION;
Address: �—f-T- LC S 4?
Legal Description:
Property Tax ID #: �—`� -- -- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
EtJona wor to e e orme un er this permit -- check
13
a
app y:
FHVAC
Gas Tank ❑Gas Piping
_
Shutters
Windows Doors
Electric ❑ Plumbing
❑Sprintclers
11
Generator
Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor: _
Cost of Construction: $ _/ p Z, Utilities:[]Sewer []Septic
OWNERAESSEE:
Name `—
Address:
City: �,�-- State:L17�
Zip Code: © cF-0 P-) Fax:
Phone No. - .
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name:
Company: (f_oc5 C
Address:
City: L State: t�7'L_
Zip Code: 3 4 '3 ,j � _ Fax:
Phone No.
E-Mail: �� �' �u• , �,
State or Country License: C_`
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DES
IGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: one
FEE SIMPLE TITLEHOLDER: Not Applicable
Name: —`
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 Nome 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordin our Notice of Commencement -
as Agent for Owner
STATE OF FLORIDA
COUNTY OF s F
The forgoing instrument was acknowledged before me
this day of P Lam— 20 i_' by
Name of person making statement
Personally Known FOR Produced Identification
Type of identification
Produced
(Signature of Notary Public- State of Florida )
oe��_
ignature of Contractor/License Holder
STATE OF FLORID
COUNTY OF r
The forgoing instrument was acknowledged before me
this o`') day of o �' a � 20 /2 by
Name of person making statement
Personally Known �roduced Identification
Type of identification
Produced
��-- C_
{Signature of Notary Public- State of Florida )
Commission No.
=z°
TAYI_ ACNE
Commission No."YiG%
T di)R GAGNE�—
Notary Public -State of Florida
=2 n' Notary ubic-State of Florid
Commission # GG 293167
Commission # GG 293187
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MY Commission Expires
January 21,
2023
023
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Rev. 8/2/17
w�rJw,�hridirectory.orgCertificate of Product Ratinas
AHRI Certified Reference Number: 7615287 Date: 05-01 2019 Model Status: Active
AHRI Type: Sp -A
Series: NUTONE P7RE SERIES
Outdoor Unit Brand Name : NUTONE
Outdoor Unit Model Number (Condenser or Single Package) : P7RE-036K
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, 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 NUMNE product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSUAHR1210/240 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 . 35000
SEER: 14.00
EER 02) - Single or High Stage (95F) : 11.00
f Active Model Status are those that an AHRI Certification Program Participant is currently producing AND sailing or offering for sale; OR new models that are being
marketed but are not yet being producad.'Producdon Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Rati ind awnvolu rat The now vubtished =is
DISCLAIMER
AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the produCks) listed on this Certilcate. 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.ahridirectory.org.
TERMS AND CONDITIONS
This CeMftcate 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 vdwW 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 users Indhridual, AM
personal and confidential reference. AIR-eONDMONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model died on this certificate can be verified at www.ahrldirectory.org, click on 'Verify Certificate' link
and enter the AHRI Certified Reference Number and the date on which the certificate was rued, we make life better -
which is listed above, and the Certificate No., which Is listed at bottom right
02019Air-Conditioning, Heating, and Refrigeration Institute f CERTIFICATE NO.: 1320t224033B6t>4. m