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HomeMy WebLinkAboutBuidling PermitAll APPLICAB E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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:J PROPOSED INPROV ENT LOCATION: Address: �� `� C Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back DETAILED DESCRIPTION OF WORK: C N _ -A . Right Side: Left Side: Lot No._ Block No. CONSTRUCTION INFORMATION: A iti na wor to e pe orme un er t is permit – c ec a t at app y: _Mechanical _Gas Tank _Gas Piping _Shutters Windows Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $o2 ' Utilities: _Sewer _Septic Building Height: OWNER/ ESSEE: CONTR CTOR: Name r Name: mpany: AddyCitStatel/ l ss. �,.� Addre Fax: City: State: Zip Code: � Phone No — Zip Code: Fax: s E -Mail: Phone No. Fill in fee simple Title Holder on next page ( if different E -Ma' from the Owner listed above)State County License: if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: Zip: Phone: 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 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_wprLgn recording your Notice of Commencement. Signature of Owner/ Agent/ Lessee STATE OF FLORIDA COUNTY OF�� LuC� The forgoing instrument was acknowledged before me this I% day of�) jiI.J-e be r 20A by Signature of Co r9EEfo`rLicense Holder STATE OF FLORIDA COUNTY OF Sa�rnk LuCi 4�t The forgoing instrument was acknowledged before me this & day of NOVA YY1Vauf' 2011 y by ilk Y fsk1 VkoMu d On YA 1h (a vlto1bjQ� (Name of person acknowledging ) (Name of person acknowledging ) (Sigkakure of Notary Public- S ate of Florida ) Personally Known \/ ®Produced Identification Type of Identification P __ Notary Public State of Florida Commission No. Christigl5il!Mond My Commission G �Q �'iof G .326704 A Expires 04/22/2023 REVIEWS DATE RECEIVED DATE COMPLETED ev. cll�' }— ; _ �A� (S41ature of Notary Publi - State of Florida ) Personally Known v OR Produced Identification Type of Identification Produce `f''"" W�O� �QJf' ;.,�, Ni., a P Commission m :;i.•�n CSG 3 COUONTER I ROEVIEW I NING S REVIEWOR I REVIEW PLANS I VEGETATIEVIEWON I SEATURTREV EWLE I M EVIEWVE Certificate of Product Ratinas AHRI Certified Reference Number : 202273692 Date : 11-18-2019 Model Status : Active AHRI Type: RCU-A-CB Series : XL181 Outdoor Unit Brand Name : TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TTX8048B1 Indoor Unit Model Number (Evaporator and/or Air Handier): TEM6AOC48H41+TDR+UF/HRZ 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 TRANE 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 (95F), btuh : 48000 SEER: 17.00 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 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 involuntary re -rate. The new published rating is shown along 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 at www.ahridirectory.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; A..■ `' 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.: 192185651259416038