HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential
I PROPOSED IMPROVEMENT LOCATION: I
Address:
PropertyTaxlD#: 34)q —670— 0074 —'100 Lot No. 10
Site Plan Name: Block No. 7'7
Project Name:
DETAILED DESCRIPTION OF WORK:
W
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank _ Gas Piping _Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name , " 0 %,O
Name:_R/K
C1006 -
Address: 6%f%JG A%( R,4/IV;5
Company:
I,9111£'f9 COo1-IA
f /Y�%/1X2
City: jeSL �� State:�L
Zip Coded.49Cl✓ Fax:
Phone No. 1W —34* —41Y4
Address:5-95
NO).. &,eek�: AF%D(a
City: ft—f
Zip Code:
Phone No
57.G0G19
,54q g 1!! Fax
'71/.1 621
State:
(¢ Zl —1 r 3 �
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail iAA0
ll Y1tDN d!J Lod
(a sUL Jj Oc1ivtl • C
State or County License.9
1- I
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.
A
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:
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 STfE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
y
Signature of Owner/ L ssee/Contract r as Agent for Owner Signature of Contra or/License older
STATE OF FLOR STATE OF FLORIDA
COUNTY OF 2 nl-FLQ(G,J COUNTYOF5A)N r LUClf.
The forgoing instrument was acknowledged before me
this' day of _AaW, 0&& 20_& by
Nam& person making statement.
Personally Known t/ OR Produced Identification
Type of Identification
(Signature of Notary Pu ftx '�}"�,fv�_of 6% #,1iie. Sato or lofida
My comm. expires Dec. 26. 2021
Commission No. Comm(fs INimber GG170664
REVIEWS
RECEIVED
The forgoing instrument was acknowledged before me
this day of 1Q2,e,&,m dog 20a by
ar a of person making statement.
Personally Known —J/-- OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public -
Commission No�4
ONT � ZONINGNTER REVIEW SREVIEWOR� PLANS RE VIE I VREVIEEGETAWON
COUNTER
JUDITH TERRO
490
o'% PnbliC. Slat$ of Fli
45hm, expires Dec. 26,
Ccmmission Namber�iG11
SEATURTLE I MANGROVE
REVIEW REVIEW
CERTIFIED
Certificate of Product Ratings
AHRI Certified Reference Number: 201498246 Date : 12-02-2019 Model Status: Active
Old AHRI Reference Number: 10206642
AHRI Type: RCU-A-CB
Series: GSX14
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX140481K`
Indoor Unit Model Number (Evaporator and/or Air Handler) : ASPT49C14A`
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, SO, TN, TX, UT, VA, VT, WA, WV, Wl, 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 ANSI/AHRI 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 : 45000
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 12.00
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 .
Ratings that are accompsaleanied by WAS indicate an involuntary re -rate. The new published rating is shown alone with the previous (i.e. WAS) ratina.
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), orthe
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 A_VN20
This Certificate and 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; ou No `'
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-0ONDmONING, 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 "u life butter°°
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.: 1321978200621ee273