HomeMy WebLinkAboutCHANGE OUT FORM - PREECEALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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) 462-15781 Commercial Residential
PERMIT APPLICATION FOR' To Select from dropbox, click arrow at the end of line
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Address: Z(k1Q) N 97
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Site Plan Name: dock No.
Proet Name:
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Additional work + erformed undd-t-th"Ns permit-- check all-- apply:
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IaJHVAC Gas Tank Gas Piping Shutters Windows/Doors
1.1 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ (0,0 L) 0 Septic Utilities: Sewer Se 1 ISSuilin@� elgihjt:
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Name Name: n4 It
Address: _t
City: State: ):�6
Zip Code: "Sq C11 Fax:
Phone No._79, Q
E-Mail:
f Ill In fee simple Title Holder on next page if different
from the Owner listed above)
AC Se, company:
Address: 5 32- Q U-) 'el QLC(e, # I
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City: Pwr-4 �i, J-u ck state: 1:�
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Zip Code: 349�.G Fax:77Q __q 3q -3!5✓
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Phone No,,
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State or County License; D:3
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
U _fJ'-P_'1�EMENTAL,C0NSPTRUL TIONUEN'tPVTV INFORM, ION's-
DESIGNER/ENGINEE Not Applicable MORTGAGE COMPANY: Ndliot ApplicaNe
Name:
Address:
City:
Zip:
State:
FEE SIMPLE TITLE HOLDER: Not Applicabl"Ie
Name:
Address.
City: —_ Zip: - Phone:
Name..
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City-p-
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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
ct 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 Oft-MUE JOB SITE BEFORE THE FIRST INSPECTION. IF INTER TO OBTAIN FINANCING, CONSULT
WITH XWR LENDER OR AN A R NOTICE OF TTORNEY BEFORE RECORDING F COMMENCEMENT."
Signature of Otvner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
--
COUNTYOF
The forgoing instrument was acknowledged before me
this day of '-a0k.-n V Ctl2i _, 2020 by
Name of person making statement.
Personally Known Or
\i R Poduced ideni i.:flcation
XL%
Type of Identification
Produced
A&A'&
(SignalftoT11111''blItIb"O ""NN I"""
.0 1 m Notary Public State of Florida
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JP '%
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# Jennifer I Aguiar Sea
4• ILA&P
G 33987I
(I 4_0 Expires 06/2912023
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
eV. 2777T9---
Signature of Contractor/License Holder
STATE OF FLORIDA
C'
COUNTY OF
The forgoing instrument was acknowledged before me
this day of ]iyLll A w20by
-IN
i <1 % 0
Name of person making statement.
Personally Known. Xt OR Produced Identificaton'—_
Type of Identification
10 ,roduced
L AdL All AL Ab—dalL A&-.
0IIIIIIIIIIIII
a)
Notary Public State of TFlorida
Jennifer I Aguiar
11 (Seal)
"N%y Commiag*paraQ 22OR71
Expires 05/29/2023
ZONING SUPERVISOR I PLANS I VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
AHRI Certified Reference Number: 201785242 Date: 01-16-2020 Model Status: Active
AHRl Type: ICU -A -CB
Series: GS'X16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package): GSX16S481 A*
Indoor Unit Model Number (Evaporator and/or Air Handier): ASPT49Dl4A*
Region Southeast and North (AL, AR, DC, DE, FL, GA, Hl, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, lD, IL,
lA, lN) KS, MA, ME, Nell, MN, W, MT, ND, NE, NH, NJ, NY, OH, OR, PA, lily, SD, UT, VT, WA, 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 GOODIiMAN product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSlhAHR1 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 : 45000
-SEER: 16.00
EEC' (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 oublished ratin alona is shown wit the xevious (i.e.WASH ratan
0000�
h
DISCLAIMER
AHRI does not endorse the product(s) Hsted on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed on this Certificate. AHRl express9y disclaims ail liability for damages of any laind arising out of the use or perform�:ance of the product(s), orthe
unauthorized alteration of data listed on this Certiflcate. Certified ratings are valid opMy for models and configurations listed in the
directory at www.ahrldirectoryx�.rc_,".
TERMS AND CONDITIONS
This Certificate and Its contents are proprie-tary products of AHRI. This Certificate shall only be usedi for individual, personal and
confidential reference purposes. The contents of this Cert-ificate may not, in whole or in part, be reproduced; copied; disseminated; *—via i IIIIIIIIIII &I
entered into a computer database; or otherwise utiflzed, in any form or manner or by any means, e;(Icept 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 wv1--,.rw.a h r i d i root* ry.org, cli4* on "Vayffy Cortifloate" link we make life belteell
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
,,,f.jhich is listed above, and the Certificate No., which is listed at bottom right.
@202OAirCo�nAfloning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132236685802456749
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser --All rights reserved.
Property Idea tHfkau'u).
Site Address:
Parcel ID:
Account #:
Map ID:
Use Type:
Zoning:
City/County:�
Ownership
Valerie Preece
James E Preece
585 Gray Rd
Greenville, TN 37743
Legal Description
INDIAN RIVER ESTATES -UNIT 09 - ELK 88 LOT 19 (MAP 3 4/12 S)
(OR 3419-2423; 2425; 3554-1580: 3617-1314)
Current Values
• Past taxes are not a reliable projection of future
taxe s.
• ne sale of a property wflR prompt the Temovnl of
ZIRR exemptions, assessment craps, P-Rd sped'al
dassificatiollis.
Taxes for this parcel: SLC Tax Collector's Office U
Download TRIM for this parcel: Download PDF 92
2003 BARTOW ST
3402-610-0551-000-3
38653
34/t2S
0100
RS-4 Count
Saint Lucie County
Total Areas
Finished/Under Air (SF): 2,096
Gross Sketched Area (SF): 3,280
Land Size (acres): 0.3
Land Size (SF): 13,125
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
(0 Copyright 2020 Saint Lucie County Property Appraiser. All rights reserved.