HomeMy WebLinkAboutBuilding Permit Application _
AII:APPLICABLE;INPO;MU5T BE COMPLETEDTO'It APPLICATION TO BE ACCEPTED
Date: ID 1.7? 20,Z 0. . Permit Number.,
Buildcng 'P+ rmit Apptteaton
'Planning and Development Services;
BulfdTnggRd Co'de:Regufation Drvisfon Cormrne!'CIaI' Redden#13I
23fJti.VTrglnlo Avenue,,Foot ftrce,AL V982;
Phone:;(772)462=1553: Fax:.()72)462-1578
PERMIT APPLICATION FOR-.
_ 1 ��pt•.1,+ R_RI ' �Fy .Yert�.xV1 �. , pi q � 't .imom
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Address: S` O. o Pr ►e � t`r c
r Property Tax ID . `CQ.D 0 0�1' 060 - Lot No..
Site Plan Name:.
Bloch No.
Project Na de
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ii eE�IcACe: Pica s,-{r'riG ,57-"
IF
J2 r'ovt el- Y[`- -
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';. New Electrical Meter Second;Electrical Meter
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F Additional work to be performed under this permit=check all that apply:
-Mechanical Gas:Tank _Gas Piping _Shutters _WindoWt/Doors _pond
_Electric _Plumbing _Sprinklers _Generator _hoof Pitch
r.
Total Sq.'Ft of'CoPstruction Sq.Ft.of.First Floor;
�l�. Of7
p Building Height
Cost'afConstructior:$ � Utilities: Sewer _Se tl,e
M,
Name?
Name?00-n,'e le ��r�.u-��er►n Name. Cody:CO►J F5, ..
Address:
.o Nn e s- i cr 1e 4 Cam any: ,
A . �
! City: State::
Address:IUCo i 7 5-. v (fie{se.r- b-)
Zip Code 3T-I G S-f. :Fax: City: FLI Sacril Luce_ _ State: P(-.
Phone.No..-2 7'Z- 7 L-?- '1J!7
Zip Code. 3 4609 Fax
E-Mail,
_
Phone No ?7 374 cl(o6
i _
I, Fill n.fee:simple Title Holder:or next page_(if:different E-Mail C n i 1 s hus trt eSS-4-r� wtig� ram
t' froiri the Owner fisted above) State or County License4 -1.SS2(j L�nr j.
if'vaiue of constroc'00 Is 2500.or fhdre,.a RECORDED Notice.of Commencement Is required.
I if'vaiue of HAUC is$7 500-or-more0.a RECORDED;Notice°of Commencement is required'.
1?ESIGNER/ENGINEER: Cot Applicable MapTGAG�.COItitIPANY _ _N,at Applicable
Dame; ._ Name;
Address.- Address;
St
-Statei City: a
te:
Zrp. Phone Phone:
Zp:
N
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:; _Not Applicable
Narne, Name:
Address: Address:
City: city:
,Zip: , Phone: zip: Phone-
OW GONTRACTC11t AFI:IDViT:Application is hereby made;to obtain a permit to do thawar and instailation:as Indicated,
F certify that no work or Installation-has commenced,prior to the issuance of a permit.
St.Lucie.Caczcittyy makes_no representation that Is.grAn-rig a permit will'authorize the perttt+t holder to.bi lid the subject structure
which is in on, .1ct with any applicable Home Owners-Assaciation:rules,bylaws.or and covenants that may-restrict.or prohibit such
strycture.Pease.eonsuit With'ybUr Hate owners.Association and review your deedffor any restr+ctians which may applw
Inconsideration of.the�graoting:of,this requested perak,i do hereby agree than w+il�in.ail iespects,.peiform the work
in.accordance with the approved pians,the Eior(da Build'sng Godes and;St.Leicie County Amendments:
The folio wing building permit applications are:ekenipt frormund'ergoing a full concurrency review:room additions,
accessory structures,swimming pools;.fences,.wail:',s(gns;screen rooms and accessory uses�to another non-residential use
WARNING TO OWNER:.Yc urfaiiure to Recorda Notice:of Commencerr>erit may result in paying twice for
irnprouements.to your property A"lVatice of Commencem°crit must b-e recorded in the public records of St.
Lucie Courity'arid pasted on the lobste before the fast inspection.if yotr intend to.obtain financing,consult
with lender or an attorne, before comrriencin work or, recordm our Notice of Comme`ncement�.
I�
R S+ at 're�of owner/Lessee/Contractor'as Agent for Owner Ili atu of,-Contractor/License Holder
�'. STATE OF FLORIDA. STATE OF PLORlDA-
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e
' S'orn to(or affirmed)and subscribed-before.me.of Sworn to(or affirmed)and subscribed before.me.of
Physical P"resence lir Online Notarization Physical Presence or- t3rii+ne:Notarization
'i. this
13"-day of 84-±gbie F` :2020 by this t3 `•' day of C}ck c .20Z0 by
Name of person maliirtg statement ' Name of personrnaking statement:.
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Personally:Known . x,^ Oi#Produced,identification Personally Known oft Produced Identification
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
CQUNTER REVJEOJ '
R1tllrtiN REVIEW REVIEW REVIEW REVIEW
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HRt•Cerfified Reference Number 202308144 Date 09-16-2Q20 Model Status Active
AHF4 Type A GS(50jit-4yste) AEr Cooled;Qtihderisitig Unit,Coitwlth Blower}:
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Outdoor Unit Brand'Name..-CHAMPiON HWnNG,AND.'GOOLING
Wi oor Una Model Number, (CondenseT'oi Sin91e Package} TC4B4222
lndoof Unit Model Nuniber{EvapP*Or andtot,Alt Handier};-AP48G?S2'I:+TXv
Region,. Southeast:and'Nortit;(AL,AF, .DG,DEI FL,,GA;,HI,KY,LA,MD;,:MS,NG,.OK',SG TN TX,, AK.GO,fvT;;ID,IL.
A,.iN;KS,MA,ME,MI,MN.MO;MTi ND;NEt NH,NJ,;NY,r OH,.OR,PA,Ri,80i,-U ,VT,11UA,WV Wt,WYN U:S:
Territories}
i Region Note: Central air.conditioners manufactured prior to JanuaryA,2015 are eligible to.tie installed In:' reglonisi
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{ which they meet the,,reglondirefflclency.requirement.
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1 Tisa m.anufaCture of thiS`:YAMPI tiE#TING AN01COOI.i�(G prodtiGt is resp4naible for�ttte rating o�tela s�ettem cogib�Ina�rtt
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Prated;as fcllovua n accordance vnth the latest edltiatrofANSLIAA'lRi,Y2-Qr240 nih Addenda 1 and 2 Pec of nsin
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Air CondRlonl89&A -Source Heat,Pump�4uipment entl subject�o railing accuracy by AHRI 5ponsolec�,[it5le n tit, r at jt r $
Cooling Capacity(A2j sit:gte or}3 gh Stage(S5F} btuh 415fl(} t
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1: "Act vo°Madel Status are those that ari.AHRi GeM'cation-PImorarn Participant is currently,f mraducing-AND seliing or offering for sale OR new models that am being_.
marketed byt aronot yet.being produced°Production Stopped°Model€Sfatus are those that an AHR!i art call Frograrra Participant ss no Longer prodgcing Sill Is;stili
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DISCLAIMVR
AHI{I does not'endorse;the pmduct(s);Ilsted orVthfs Certitioaterend makes:no representations,warranties or guaranfp(was to,_and assumas;no msponsibifity-for
{ the proddct(s).listed ow-this Certiticate..AHRI expresstydisclaims all liability,fordamages.-f anyklnd arising opt of roe use or psrfcrinancs of_.the product{s};or:,tha
unauthorfzedalteratlon:of_da#a I[sted qn ttiis•Certiftcate;Gertitied ratings arevalid only far madels;and canflgurations listed In'tha
(; directory at"wwWx ahiidtidetory.org.
i• TERMS AND.CONDITIONS
i Tiiis;Ct rtfficate;arid tts,contents are"proprletary'products:of.AHRi.Tbis Ceitiflcateshall aniy.ba'usedlot.individual porsonai and
cori€idenflal'referenoo purposes.The contehis'of this Certtflcate•may net,fn whole or In part,be reproducedtcopled,dissaminatedr q
i, entered`Hies computer:database;ar`othe,rwise.utiti ed,in:any qrm or manner'or:6y any means;ezcep#for. he asst's individual:-
persoaai and confidential reference:
AItYC(ttYDITtONiN6,E#EATING;
1y &KEfRItSERATION INSTITUTE
h 'CERTIFiCATE.VEMFICATION
The,information forthe model clted'on this.certtficate cart ba verified atwwisr,ahrld[rectory qrg,eiiok'or "Verify Certfficato°Zink wwmake life better"'
and enter the.AHRi Certified Reference Number-and.the date"btrwhlcb the'certificate was{sued,
r; which is iisted above,mpd the Certificate No.,'whrch is listed at bottom right . trxz rr;t6c e ti
137,Q4758�6 S�tYfl
1. Gi202i�Atr=Cbndo .091,Heating,and Refrtgerafon{nstituteifi
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