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HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Kermit Number: - a �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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Legal Description; c_; j "� Q Property Tax ID #: - D D Site Plan Name: Praect Name: Setbacks Front Back: Right Side: Left Side: Lot No. -- Block No. DET I ILE DESCRIPTION OF Wof l�: iLcll �:� 3 ;ter, /,9c_c r-C�i•"� f 1 C r� 1 �r r"r I + ,7 7 CON. RUCTION:INFORMATLON: -AOtoa app y: wo tio oe rme un er this perm —check affShu HVAC Gas Tank ❑Gas Piping ##ers D Windows/Doors Electric 0 Plumbing OSprinklers Generator Roof Roof pitch Total Sq. Ft of Construction:. �_ S . Ft. of First Floor: Cost of Construction: $ Utilities:11Sewer []Septic Building Height: ht: OWNER/LESSEE: CQ1 T A TQR:. Name "-`c_ ca Name: ` L� Address: �� L� Company L ., ., C ' City: `�'� ScL._ State: Address: Zip Code: 2 Fax: City- f L State: i= C"- Phone No. (� P c'� . 3 Zip Code: 3 3 Fax: E-Mail: Phone No. .2- Fill in fee simple Title Holder on next page ( If different E-Mail. `. C L , from the Owner listed above) State or County license: C 11 ..­ "' `"""' ULuuu u � mm or more, a ntocinutu nonce air wmmencemem is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: T Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: �T 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 lender or an attornev before commencine work or recordine vour Notice nf ronnimprirpimprit_ ignature of Owner/ Lessee/Contractor as Agent for Owner Sign ture of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA, COUNTYOF COUNTYOF -'i'-- Lt- Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of ,_1.,--Physical Presence or Online Notarization ysical Presence or Online Notarization this J_e day of 1-4 c,.1 2020 by this day of 2020 by - I' Vic—_ C- G .-, Name of person malting statement. Name of person making statement. Personally Known :IOR Produced Identification Personally Known � OR Produced identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission NO. Public state of FloCommission ,,,�VP�..�YLOR GAGNEINS mission No. # GG 2931 ° +, TAYLORGO�W Public-Sta ,Notary Hoary 21, 2023 '; ommission # 3REVIEWS ° FRONT VEGET Cis °SEAA�y 2 COUNTER REVIEW REVIEW REVIEW REVIE DATE RECEIVED DATE COMPLETED Kev. 5/b/20 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 : R410A AC SPP Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS Outdoor Unit Model Number (Condenser or Single Package) : PA4ZNA0360D0-- 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 ANSI/AHRI 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 1"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. Rahn s that are accompanied bX WAS indicate an involuntary % rate. The new_publiish_ed rating is shown alon with tile-provious i.e. 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 ;:�•t*:.2t-idireciory.c sg. TERMS AND CONDITIONS O� r 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, personal and confidential reference. AIR-CONDITIONING, HZA7.; iG, 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. -- — ©2020Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132433872435561699