HomeMy WebLinkAboutmatternALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date: .- -.._ Permit Number:
R
Building Permit Application
Planning and DevelopmentServices
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL .34.982
Phone: (772) 462-1553 Fax: (772) 462»1578 Commercial . Residential
PERMIT APPLICATION FOR: To Select from dropbox, clack arrow at the end of line
PROPOSED IMPROVEMENTIOCATIOUC.
Address: tf:S"i
Legal Description:
Property Tax ID #: - ra S~- _ 0 C)�C) --
Lot No.
Site Plan Name:
Project Name: Block No.
Setbacks Front Back: Right Side: _ Left Side:
U0A1LED DESCRIPTION OF WORK;
c._.L2, ; �
►U.CTION:- INFORMATION:
aaitiona wo to e pilfdrmed uncerihisoZerm — c
OHVAC Gas Tank ❑Gas Piping
LiElectric Plumbing Sprinklers
-�, ; r__t
Total Sq. Ft of Construction: / 3
Cost of Construction: $
OWNER/LESSEE:
Shutters windows/Doors
Generator Roof Roof pitch
Ft. of First Floor: _
Utilities: OSewer 11Septic
Address
City: State: AL1
Zip ode: Fax:
Phone No.,
E -Mail:
Fill in fee simple Title Holder on next page ( if dI ferent
from the Owner listed above)
Building Height:
c.vl�,#CTOR:
Company. �.r`,-,� i
Address: y
City: zo &---f State:_47-C
Zip ode: _3 �/�'.S'3 Fax:
Phone No,
E -Mail:
State or County License: ,"
N value of construction is $2500 or more, a RECORDED Notice of &Mmencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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.
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 ,paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with leer an attorney before commencing work or recordingour Notice of Commencement.
Signature of Owner
r as Agent for Owner I Sig6ature of
Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ .S F ( �C_ c_ � c__ I COUNTY OF S,E
Sworn to (or affirmed) and subscribed before me of SwornW4or affirmed) and subscribed before me of
c�ysicai Presence or Online Notarization LIPhysicai Presence or Online Notarization
this L(day of -__ e[o+--- .2020 by this ,L(2day of 55Z,� 2020 by
Name of person making statement. Name of person making statement.
Personally Known _,.�:�_OR Produced Identification _
Type of Identification
Produced
(Signature of NotJ�- y ACNE
Rti {PRY Pvj•,l
No Public•Stat of Florida
Commission No. *= Commissio�I 293187
'r;Fo F aPr
.-Y Commission Expires
yanuary 21: 2023.
REVIEWS j I FRONT I ZONING
COUNTER REVIEW
RECEIVED
DATE
COMPLETED
Personally Known t,-"�_OR Produced Identification
Type of Identification
Produced
(Signature afNE
otary f Florida
_z
_'
Commission N
u is tate
*= Commission # G2333�187
My
.� �._ _
CommissioNO es
.!unuary 21, 2023
SREEORIEEVEGETATIONIS EELEIMREMANGROVE
REVIEW REVIEW REVIEW REVIEW
Certificate of Product Ratinas
AHRI Certified Reference Number: 8215491 Date: 08-31-2020 Model Status : Production Stopped
AHRI Type: SP -A (Single -Package Air -Conditioner, Air -Cooled)
Series: R41 OA 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, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, 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 2101240 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
t"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 stilt
selling or offering for sale.
Ratinas that are accompanied_bv WAS indicate an involuntary re -rate. The new published rating is shown alono with the Previous (i.e. WAS) rating.
DISCLAIMER
AHRI does not endorse the products) 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.oig.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI.Thls Certificate shall only be used for individual, personal and
W. -
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, AV In=
Uaffid
personal and confidential reference. AIR-CONDITIONING, NZ;, ;7r4G,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at click on " link we make life better,
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 CERTIFICATE NO.: 132433872435561699