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Home My WebLink AboutBuilding PermitAll APPLICABLE. INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DatePermit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Building Permit Application Commercial Residential „-x' Address: /'.-;Ps 1.21 'L4 'q �" � � � � � �.°. j "i 29 Property Tax ID #: ` 1I Y 0 Lot No.J4 Site Plan Name: Block No. Project Name: 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: Cost of Construction: $ � '' Utilities: _ Sewer _ Septic Nam 1rci 1 7 L&' r`-� P_ Address: P � r r City:. e" ` j e State:h&,A Zip Code: Fax: Phone N-�6r E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: Address: 3&/ ) -i Sim _ 4} A, r'i AZA , City: 1_�; L. State: F'- Zip Code: 3 4. S 3 t Fax: w Phone NW -+f) E -Mail i i` ��`7 0 �C' State or unty License" Windows/Doors 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. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: Produced 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 SITE BEFORE THE FIRST INSPECTION. IF -YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN_A4;TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Rev. 2/7/19 Signature of OwneseJ44ror as Agent for Owner Signature of Contra rc er STATE OF FL COUNTY OFORIDAS �(dGt+L STATE OF COUNTY OFORIDA ,� /�� The forgoing instrume twas acknowledged before me The for oing instrum� .was acknowledged before me this da of (, U&r 20,)P by this day of_,VA14—: 20-�di by -y T _Name f pe _ onpaking ate ent. ,OR ment. Name clf pers n maki7IR Personally Known Produced Identification Personally Known Produced Identification Type of Identification Type of Identification Produced Produced �tJi �Wc'd> Jsr1,0 (Sig 'ature of Notary Public- State of k i a (Signature If Notary P ,,o��/> J ss F��iiESNILLO Commission No.t!�(rJtate Public _ .�"Y"'�, JOSE FRESNILLO Commission No. State otdl�-Notary Public oft�tla-Notary Commission # GG 272747 ; Commission74 Commission ExGG 72res? M Commission Expires- .'� o�: y p December 22, 2022 P�R'C REVIEWS FR """ PLANS VEGETATI EA TU R TIE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19 Certificate of Product Ratings AHRI Certified Reference Number: 10261738 Date: 06-16-2020 Model Status : Active AHRI Type: RCU-A-CB Outdoor Unit Brand Name: FUJITSU Outdoor Unit Model Number (Condenser or Single Package) : F03014CSJ Indoor Unit Model Number (Evaporator and/or Air Handler) : FB21TS Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, WI, WY, U.S. Territories) Regan 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 instailed in region(s) for which they meet the regional efficiency requirement. The manufacturer of this FUJITSU product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210240 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 : 28600 SEER :16.00 EER (A2) - Single or High Stage (95F) : 13.00 -p'Actme Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are ming 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 Mpg or offering for sale. Ratings chat are aceomganied by WAS indicate an involuntary re•rate. The new published ratirw is shown along wyh 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.ahrldirecte. y.W.& TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI_ This Certificate shall only be used for individual, personal and Ain 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 arryform or manner or by any means, except for the user's individual, Arm personal and confidential reference. AIR4WNMf10RtNR: . CERTIFICATE VERIFICATION & REFRUMMATION IIi81?fM The Information for the model cited on this certificate can be verified at www.ahrldirecta? y.w g1, click on `Verify certificate' link we make fife bei, 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_ 02020Air-Conditioning, Heating, and Refrigeration Institute i CE€ MFICATE NO.: '32w7"0428'525"