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HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEp D Date: - Permit Number: Planning and Development Services Building Permit Application 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 PROPOSED IMPROVEMENT LOCATION. Address: Legal Description: Z�c C_4- Property Tax ID #: Site Plan Name: Project Name: Setbacks Front DETAILED DESCRIPTION OF -ONSTRUCTION INFORMATI N. s:_-- .... 1Gu HVAC {� _______0GasTank Electric El Plumbing Total Sq. Ft of Construction: Cost of Construction: OWNER/LESSEE: Lot No. Block No. Right Side: __ Left Side: f�.-�•y�f � �. � icy �. � � ; �` W. Piping Sprinklers Name . Addre s: City: c_ State• Zip Code: .3 Fax: Phone No. L E-Mail: LJ Shutters Generator S . Ft. of First Floon _ UtilitiesIlSewer USeptic Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Windows/Doors Roof Roof pitch Building Height: ..CONTRACTOR: Name: Company: f> [ Address: City: s State:J _c Zip ode: .3 -•l v:_ r 3 Fax Phone No. E-Mail: e State or County License: e— if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN IN -FORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: Zip, Phone State: Zip: ____ Phone:_ FEE SAMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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: Yourfailure to Record a Notice of Commencement may result in paying twice for improvements to your property . A Notice of Commencement must be recorded in the public records of St. Lucie County and pasted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an-attornev before rnmMencing work or recordin our Notice of Commencement, ____, Not Applicable ignature of ow er Le tFactor as Agent for Owner Signature of Contractor/Llcense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ` C��< COUNTY OF S �` (_, Sworn to (or affirmed) and subscribed before me �f�ysical Presence of Sworn (or affirmed) and subscribed before me of or Online Notarization this ,- / day of � 2020 by Physical Presence or Online Notarization this day of 2020 by [Name of person making statement. Name of person making statement. Personally Known k!:�OR Produced Identification Personally Known FOR Produced identification Type of identification Type of Identification Produced Produced .`�yar��•lkaf J ., i re o otary u Iic- ate of 4� `` (S' nat IF Notary Public- ate of orida ) Commission No. Seal (Sea[) 0 m Commission No. �] (Seal t ,gas*`tip. REVIEWS FRONT ZONING t3ma� Oitil PLANS VEGETATION SEATURTLE 'g rty, 11�u n 1 AAN69M COUNTER REVIEW REVIEW REVIEW REVIEW aj DATE RECEIVED Wa z Z33 y DATE C6- a COMPLETED N X w a ca Z why • u�■�:1 CERTIFIED www.ahridirectory.orgCertificate of Product Ratinqs AHRI Certified Reference Number: 8215491 Date: 08-31-2020 Model Status : Production Stopped AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled) Series. R410A AC SPP Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS Outdoor Unit Model Number (Condenser or Single Package) : PA4ZNA036000-- Region : All (AK, AL, AR, AZ, CA, CO, CT, OC, 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, Rl, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, 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 BRYANT HEATING AND COOLING SYSTEMS product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSIIAHRI 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 : 35000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 11.50 -"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 accom nied by WAS indite anan involuntary re -rate The new oublished Wig is sh wn alp wiwith the previous (i.e. WASH rating. �. _. DISCLAIMER f - AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibilityfor, 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 wJaw.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its 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; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, A m® uawd personal and confidential reference. Air --CONDITIONING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at click on "" ° link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, vw make life better - which is listed above, and the Certificate No., which is listed at bottom right. — — -- - - ©202OAir-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132433872435561699