HomeMy WebLinkAboutBuilding Permit ApplicationI
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO -BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23o0 Vitgiriio Avenue, Fort Pierce FL 34992
Phnnp-(7721462-1553 Fax: (772)462-1578 Com_mercialResidential
Property Tax ID #: - U00 Lot No.
Block No.
Site Plan Name:
Prr%iArt Nnmp!
Additional work to be performed under this permit -check all that apply:
—Mechanical Gas Tank —Gas Piping — Shutters
Electric Plumbing Sprinklers — Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cast of Construction: $ Utilities: —Sewer _Septic
city: State; tL
Zip Code'. )Ji Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( If different
from the owner listed above)
windows/Doors
Roof — Pitch
Building Height*. _-
Name: , ')'W1 U I
Company:
C4,11 ft�t-s
Address:
City* Statel—t.-
F�a x:
Zip City:
,,fit
Phone No jj
E-IMail
State or unty License
I 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.
-Not Applica
Name,
Address: State:
city:
Phone
Zip: ---.
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Not Applicable
Name:
Address: State:
City:
Zip. Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
is hereby made to obtain a permit to do the work and installation as in icat
OWNER/ CONTRACTOR AFFIDVIIT.
Application
I certify that no work or installation has commenced prior to the issuance of a permit,
,ation that is granting a permirules
,will authorize the permit holder to build the subject structure
St, Lucie Count makes no represeril u les, bylaws or and covenants that may restrict or prohibit such
which is .conflict with any applicable Home owner
wners Association r apply.
structure. Please consult with your Home s Association and review your deed for any restrictions which may app Y
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,
exempt from undergoing a full conc
The following building permit applications are urrency review: room additions,
uses to another non residential use
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE F COMMENCEME14T MAY RESULT IN YOUR PAYING
TWICE FOR IMpRovEmENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
jSPECTION.X YOU INTEND TO OBTAIN FINANCING, CONSULT
pOS)kEv ON THE JOB SITE BEFORE THE FIRST It i :EMENT."
IDINC UR NOTICE OF COMMENC
—alr,U Vnt10 LCMDER OR AN ATTORNEY —8F-'FTR—ERkC0I
of Owner/ Lessee/Contractor as Agent for Owner
STATE Of FLPRIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this X& day of, E!-� '' ._� 20"7& by
Name of person making statement.
Personally Known _Z OR Produced Identification
Type of identification
Produced
Signature of — Kota a-q-, FrD�lc- State - te of Florida
T.71r8 }NSrotary P0110 SWO Of
40 y
Commission Noa-qV5 q 14 ---4—
4F Britil, Klein
Gr
-4 My Commission GG 2
REVIEWS FRONT I ZMUIM— — r 3L7FtKV13
COUNTER
OUNTER REVIEW REVIEW
6-A—TE'
RECEIVED
DATE
COMPLETED . . .......
a�tureof Contractor/License Holder
St)ATE OF FLORIDA
,
UNTY OF
The4&oing ins ru t was acknowledged before me
thlsi;� -,� day of --C 20 —& > by
Name of person making statement.
PersonallyKnown OR Produced identification
Type of identification
Produced
of Notary Public- State of n votary fpui*c state 4
grunt Klein
It
My Commission GG
loll 1/2022
n No. Z&-%o T�
VEGETATION I _EATURTLE MAN GROVE
REVIEW REVIEW REVIEW �REVIEW
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 31, 2016.
TrMm- 4M
AHRI Certified Reference Number : 7501870 Date! 02-28-2020 Model Status 'Active
AHRI Type -, SP-A
Series -, SILVER
Outdoor Unit Brand Name: AMERICAN STANDARD
Outdoor Unit Model Number (Condenser or Single Package): 4TCC4036AI
Region: All (AK, AL, AR, At', CA, GO, CT, DC, DE. FL GA, I'll, 10. IL, IA. IN, KS, KY, LA, MA, MD, ME, Ml, W MO, MS,
MT, INC, NQj NE, NH. NJ, NM, NV, NY, OH, OK OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, Wt, WY, U.S.
Territories)
Region Not*: Central air conditioners manufactured prior to January 1, 2015 are eligible to be Installed in ail 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 AMERICAN STANDARD product is responsible for the rating of this system combination.
Rated as follows.in accordance with the latest edition of AHRI 2101240 with Addendum 1, Performance Rating of Unitary Air -Conditioning
& Air -Source Heat Purnp Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing'.
Cooling Capacity (A2) - Single or High Stage (95F), btuh * 37000
SEER: 14.00
FER (A2) - Single or High Stage. (95F) : 12.00
t"Active" model status are those that an AHRI Codification Program POrticillsnl is currently producing AND selling or offering for salle; OR new models that are being
marketed but are not yet being producati."Production Stopped" MOdAI Slatus are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling ?[jng,for
"a"-.-t-
W2 rai
at€n,,�WAS indicate i k- TenWbhWtatonwf he,us na.
..
DISCLAIMER sentattorm warranties Of guarantees as %0. and assumes no responsibility for.
AHRI does not endorse the product(s) listed On this Certificate and makes no retire
the product(e) listed an this CertlficaW AHRI expraosty disclaims all liability tar damages of tiny kind arising out at the use Or performance Of the product(s), or the
unauthorized alteration of dote listed on this Certificate. Certified ratings are valid only toy models and coritlgurotlons listed In the
directory at www,ahridtfactorY,org.
TERMS AND CONDITIONS
This certificate and Its contents are Proprietary products of AHRL This Certificate shall only be used tot Individual, personal and
confidential reference purposes. The contents of ihis Certificate may not, in whole or in part. be eeprodoaed; copied; dhisemina..; AM
entered into a computer databasai or Otherwise utilized. in any form or manner or by any means, except for the user's individual. AIR GtS4ID€TIOHiNG. HEATING,
perSonal and confidentlat reference. x REFWQEAATI0N INSTITUTE
CERTIFICATE VERIFICATION
The information tar the model cited on this certificate can be verified at www.ahridirect0rY,0rV, click On *Verify C#ttilicatel link
and enter the AHRI Certified Reference Number and the date on which the certificate was issued, il- 1-1-1- 1-1-111
which is listed above, anti the Certificate No.. which I-, listed at bottom tight. CERTIFICATE NO.: 132273730306250736
02020KIr-Conditioning, Heating, and Refrigeration Institute