HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C9 Permit Number:
j
s
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 ResidentialC —
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: ,.-/
Legal Description: =T—LC5 -Z:-; Lc- ,z2 i.-x_ L Z2 0
C
PropertyTax ID #:y ��q Lot No.
Site Plan Name: - Block No.
Project Name:
Setbacks Front Back: Right Side
Left Side:
DETAILED DESCRIPTION OF WORK:
mac_/G�
CONSTRUCTION INFORMATION:
-AdUitiona wor to a er orme under this permit -check all apply:
�HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: C S7Z: S . Ft. of First Floor:
Cost of Construction: $ � Utilities:n Sewer []Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name S c:)
Name: sf �.
Address: "'7 S (_r/>
Company:
City: > State:
Zip Code: Fax.
Phone No. l
Address:
r
City: �- i 1�— ��. State: Y�
Zip ode. c-f ��f`3 Fax:
Phone No. � " /e, � -t F
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
-.—
E-Mail:
State or County License: t} C.._
it vague or conscrucuon is �>Zsuu or more, a KtCURDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ur-31 MtK/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
-------------------
FEE SIMPLE TITLE HOLDER: 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 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
improvements to your property. A Notice of Commencement must be recorded and posted on
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying trv€ce for
before the first inspection. If you intend to obtain financing; consult with lender or an attorney bthe jobsite
efore
Commencingwork or recording your Notice of Commencement_
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S s' QC_, 4-
The forgoing instrument wwas acknowledged before me
this Q day of c_f 20�by
Name of person making statement
Personally Known ----6R Produced Identification
Type of Identification
Produced
of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing Instrument was acknowledged before me
this 10 day of 0 -- r 20 f 9 by
Name of person making statement
Personally Known L'OR Produced Identification
Type of ldentific ion
Produced`4—
(signature of Notary Public- State of Florida } (Signature of Notary Public- State of Florida
gnature of Not�� }
Commission No. — % Y TCommission No.
A L4R GAGNE
Nx?iti,'y PUbfir-state of Florida ,��ozARYP�ar�� TAYLC3R GAGNE
_ *= Commission # GG 293167 ^= r= otary Public -State of Flori
zC =
Tres - "= Commissi
u' Januar ';Fo F o�,' vty Cr rr i sii n Expires
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REVIEWS FRO LANS VEGETATI "5 '
COUNTER REVIEW REVIEW REVIEW REVIEW
GATE
DATE
COMPLETED
Rev. 8/2/17
MEN
Certificate of Product
Ratin
AHRI Certified Reference Number: 7615287 Date: 0"1-2019 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.5.
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 NUTONE product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSIIAHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary
Air-Canditioning & 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 : 350M
SEER :14.00
EER 02) - Single or High Stage (95F) : 11.00
t"Activer 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 Slapped` Model are those that an AHRI Carfificatlon Program partid
eel ng or offering far sale. pant is no longer producing BUT is stilt
WAS i involuntary ZUAuiglied MggLgs shown ad-WW with the Pivviousi.e. A
S) rafina.
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certficate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed on this Certificate. AHRI expressly disdalms 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 COM#wte. Certified ratings are valid only for models and configurations listed in the
directory at www.abridiFectory.org
TERMS AND CONDITIONs
This Certificate and its contents are proprietary products of AHRL This Certtticaie shall only be used for indlvidual, personal and
confidential reference purposes, The contents of this Certificate may nK In whole or in part, be reproduced; copied; Personal
dissern110
oted;
AMW
entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's ladhNual,
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
and enter the AHRI Certified Reference Number and the date on which the Certificate was Issued, we make life better"
which IS listed above, and the Certificate No., which Is listed at bottom right.
02019Air-CondWoning, Heating, and Refrigeration Institute CERTIFICATE No_1=12240nm4m