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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I�z•PJ y �L� L Permit Number: �� L�o ILUCE RECEIVED O FER 2 4'.1011 BuildingPermit Application pP 13oftfting Department Planning and Development Services St. Lucie ounty Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: J Address: __y C/l j /''' yd�'�-�� Property Tax ID#: -s`4 �- Lot No. Site Plan Name: Block No. &b Project Name: DETAILED DESCRIPTION OF WORK: Z7 New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Lug Utilities: —Sewer —Septic Building Height: -OWNER/LESSEE: CONTRACTOR: Name - A-08 C a- fir!;='1- t;J�=ZL� Name: Address: m.yp _b Company: City: t f-IcrLL_. ��l Stater. Address: zJ PQSV,11-6 0 Zip Code:, Fax: City: ,. (i t.a State:Y—& Phone No. — Lf�s� = J� Zip Code:3`/2?,6o Fax: 772- gN-003,6 E-Mail: Phone No 7 Zd- 'V0I L Fill in fee simple Title Holder on next page(if different E-Mail L)P-,0)u�; c- !7 from the Owner listed above) State or County License c. 1 ✓ �� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. Y � ., .- _ _ _ . -, •.a �. � .. _.. � = 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 TITLEHOLDER: _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. 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 attorney before commencing work or recording our Notice of Commencement. Signature of Ow6erl Les ee/ ontractor as Agent for Owner Signature of Contractor/Li ense older STATE OF FLORIDA ��. , C STATE OF FLORIDA S� COUNTY OF COUNTY OF "'�'��� �• Sw to(or affirmed)and subscribed before me of Swor o(or affirmed)and subscribed before me of Physical Prese a or Online Notarization Physical Pres ce or Online Notarization this day of ?0�0'6y _2 1 this�day of d/.� 2 by v?) Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Nota ublic-State of F o6d3 - - (Signature of Nota ublic-State of Florida) c vr. AUDREY B.Hl3MPHREY Commission No. :}e, 17 Commission N UDREYB ---- Y a7 ;'Yo .HI'� YCOMMI�)) GG 3G08 EXPIRES:March 6,2023 r° My COMMISSION#GG 3G0817 — nh!ic Underwriters L1-* tj 1 °' i arch 6 2023 u — "'•'�o=v"' 8o ded Thru Notary Public U derwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VET=TA-TA''6N� ff &OVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED. DATE COMPLETED ev. This combination qualifies for a Federal Energy Efficiency Tax Credit when o placed in service between 1/1/2015 and 12/31/2020. Nual CERTIFIED Certificate ®f Product Ratings AHRI Certified Reference Number:201785534 Date:02-23-2021 Model Status:Active AHRI Type:RCU-A-CB(Split System:Air-Cooled Condensing Unit,Coil with Blower) Series:GSX16 Outdoor Unit Brand Name:GOODMAN Outdoor Unit Model Number (Condenser or Single Package):GSX16S361M Indoor Unit Model Number(Evaporator and/or Air Handler):ASPT47D1W Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,TX,VA,AK,CO,CT,ID,IL, IA,IN,KS,MA,ME,MI,MN,MO,MT,ND,NE,NH,NJ,NY,OH,OR,PA,RI,SD,UT,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 GOODMAMproducf:is responsible for the rating=of this system combination Rated as follows in accordance with the latest edition of AHRI 210/240 vuith Addendum 1 Perfo m(ance Rating of Unitary Air Condihonmg, &Air Source Heat.Fump Equipmyentand subject to rating accuracy by AHR sponsored indepen@5dent third party testing ,p t_ 3 i 1 S } r__ �4 Cooking Capacity(AZ) ,Single or High Stage(95F) btuh 35000 s ; ,i i I t I SEER 1600 .Z Irk EER(A2)-Single or Hlgh Stage(95F) 13 00 -i"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 for by WAS indicate an involuntary re-rate. The new oublished rating is shown along with the previous(i.e.WAS)retina. 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 ANA 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,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION.INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on`Verify Certificate"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. Fx z ,s2sassos,3s2s771i3 ©2021 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO