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HomeMy WebLinkAboutBuildilng permit appAll APPLICABLE INFO M It Date: MPLETED FOR APPLICATION TO BE ACCEPTED 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 TYPE: Address: Property Tax ID #: Site Plan Name: Project Name: VA) Lot No. Block No. Additional work to be performed under this permit —check all that apply: _Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors X Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: Sewer Septic Building Height: If value of construction is S2500 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. __ 7 T. 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: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 OMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A 'NOTIC OF COMMENCEMENT/ IUST RECORDED AND VOSTED ON THE -16B SIT��F�ODouiFrnnlr. RE THE FIRST INSPECTION. F YOU INTEND TO O)BT'AIN CING, CONSULT �Jvvrru'vnil ID I VNna nD e�K� Atpv RipFnPF Rrngt` 1110 NnTlrFF cnM nN[ " /Jff F S} n ture of Owner/ Lessee/Cont actor as Agent for Owner Sign tur of Contractor/License H Ider STATE OF FLORIDA STATE OF FLORIDA COUNTY OF PALM BEACH COUNTY OF PALM BEACH The for oing instrume liqnowledg efore me this day of 20y The f r ing instrume t c nowledge� &fore me this day of. 20 by TODD BOYD TODD BOYD Name of person making statement. Name of person making statement. Personally Known X OR Produced Identification Personally Known X OR Produced Identification y f Ide itification Typ f Ide tific ition u Proaqed lag (Signature of Nota Public- State o\``��,�,E.MAG(�y/�j ) (Signatu1Uv State of FloridaIft Commission No. •WER 1g�O�•• "„I`II"+I,',, Commission No. �'�"OLEMq��/ii�� '� o° �`' � ,� cotes �, .• SUPE b.F PLANS VEGETATION SEA TI E N)&A GR t REVIEWS FRONT � COUNTER R ,� py� ed .. REVIEW REVIEW REVI o W �DATE STA�������� 9'? pb��adlha�0�;%� RECEIVED /jell nd DATE COMPLETED AHRI Certified Reference Number: 10259412 Date 06-30-2020 Model Status: Active AHRI Type: RCU-A-CB Series: ELITE EL16XC SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : EL16XC1-042-230A** Indoor Unit Model Number (Evaporator and/or Air Handler) : CBA27UHE-042-230*+TDR Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, NO, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SO, 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 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.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, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahrid!rectory.org, click on 'Verify Certificate" link we make life betwr- 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. (�ER FIC T — E N •• v 132380200666569171 ©202OAir-Conditioning, Heating, and Refrigeration Institute j F