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HomeMy WebLinkAboutCHANGE OUT FORM - FERGUSONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: to tzo 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 KN . `A c•< 4h {���' ....r.;ry, n M b _ .4,v y '�' . CAt GN" 77 Address: 'kk , t-"- ! e g a I Description. I L) �0' 21A �j 0 1��' N Property Tax Lot o. Site Plan Name: Block No. Project Name.- 0j Setbacks Front I Back-, — Right Side: Left Side-� ­77 N't Add d it1dria Wdrk to t r Is per m �It — �c� i e �c, a p p FT,, Y 44HVAC as Tank FiGas NPIng S-Nutters Windows/Doors Electric Plumbing Sprinklers E_—Geanerator Roof Rodr)"��tch Total Sq. Ft of Construction: Sq. Pt. of First Nbpr: U t I Sewer Cost of Construction.- flAtles Sept'l Building Height, Name r) Address: IJ 0"i J'u C T State: 4 Zfl'� P C o d e Fax-,. Phone No, <K C-41 E 41� ed' Fill in fee simple Title Holder on next page ( if different from the Owner listed above) If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. UPPL.I, I t W n IC ON T NFO 'j';"istpINT" UEN 7777`;777 kiN E RJE N G IN EE R Not Applicable MORTGAGE COMPANY. Not Applicable Name: Name: Address: Address: 0wo State: cfty Z i 3 Phone,. ZIP9 P h o n e: FEE SIMPLE TITLE HOLDER: Not Applicable 6 0 N D I 1 C 0 �dI,, RU IV' —Nont AppHMabie 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 hermit 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 I E JOB SITE BEFORE THE FIRST INSPECTIONa IF YAW —INTO D TO OBTAIN FINANCINGt CONSULT WITH jS�R ENDER OR AN AJ(TORNEY BEFORE RECORDING YOtfR NOTICE OF COMMENCEMENT." Signature of OWner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA o COUNTY OF The forgoing instrument was acknowledged before me this day of Q-1.'ry ► 20?0 by Name of person making statement. Personally Known - X I OR Produced Identification Type of Identification Produced Moll AL NOL ka- pillifolbfte" 1111111111 A"11111111111111�111111111 (Signs Notary Public State of FlorWa Jennifer I Agular m Comi I .!?j.I X b1filloc-0-mmi"o G3398745ea Expires 06/29/2023 &L AAL-A6 lft� do, 'Ak REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED ev. 2.7111V Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF dv The forgoing instrument was acknowledged before me this .0 day of Ur* 20, : by Name of person making statement. "I Personally Known /14 — OR Produced Identification Type of Identification Produced Notary Public State of lion ennifer I Agular C in Nth (Seal) GG 32- 71 Expires 06/2912023 SUPERVISOR I PLANS I VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW il L AHRI Certified Reference Number: 201290221 Date: 01-10-2020 Model Status : Active Old AHRI Reference Number: 7942888 AHRI Type: RCU41-CB Outdoor Unit Brand Name: RUUD Outdoor Unit Model Number (Condenser or Single Package): RA1642AJl Indoor Unit Model Number (Evaporator and/or Air Handier): RHIT4821STAN Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, Ml, MN, MO, MS) MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, Ill, SC, SD, TN, TX, UT, VA, VT, VVA, WV, WI, VVY, 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 RUUD 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: 41500 SEER: 16.00 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 areaccoTPPXMWM�. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and snakes no representations, warranties or guarantees as to, and assumes no responsibflflty for, the product(s) listed on this Certificate. AHRI expressly diWairns all liability for dannages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Cevtifled 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 AHMI, 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, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this: r-6--rtific:Rtc- cyan �e verified at cUck on "Vorify Covtlflcaw Pink 0 - we make life betterT 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 bottorn. right. @202OAir-CondKilon�ng,, Heating, and Refrigeration Institute CERTIFICATE NO.: 132:231615427335583 Michelle Franklin, CFA­SaintLuc�e County Property Appraoser--Afl roghts reserved. Pro pe, LrT,,y7 He rM'dfirlc av-doWl Site Address: Parcel ID: Account #: Map ID: Use Type: Zoning: City/County: Ownership Ann Ferguson 4.21 S Naranja AVE Port Saint Lucie, FL 34983 dal Description RIVER PARK -UNIT 4 BLS. 35 LOT 17 (MAP 3 4/2 8N) (OR 7 5 8 -5 7 5, 576, 577, 578) Current Values Just/1\4 arket Value: $176,000 Assessed Value: $82,408 Exemptions: $75,500 Taxable Value: $6,908 .... . .... .... ... . . ..... ..... ..... ...... 7 -7-11 Property taxes are subject to change upon change of ownership. • Past taxes are not a reliable projection of future taxes. The sale of a property will prompt the removal of all exemptions, assessment caps, and special classifications. Taxes for this parcel: SLC Tax Collector's Office 0 Download TRIM for this parcel: Download PDF 12 421 S NARANJAA_\E 3419-530-0114-000-5 42514 34/28N 0100 RS-4 Count Saint Lucie County fflin VIA M-S --, Finished/ Urider Air (SF): 1,876 Gross Sketched Area (SF): 3,100 Land Size (acres): 0.32 Land Size (SF): 1400 All information is believed to be correct at this time, but is subi ect to change and is provided without any warranty. (0 Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.