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HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: - m �l Permit Number.
� Y;
Building Permit Application
Planning and Development Services
Building and code Reguladon Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1S78 Commercial Residential = ;
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED tIVIPRVMEIUT LOGth`ION.
Address: Z�4 c--/ 7_L<_ & C r -J7
Legal Description:
Properly Tax !D #• (D - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
WAILED DESCRIPTION OF WORK
C C- ,- 3 ��-, �� 1c,- S q s ,�--
5 - t G c - c c� 0
C i�S,.RUCTfON:IIUFC?RMA
itiona -worlctbo rm under is perm - e a apply.
HVAC 13 Gas Tank [:]Gas Piping Q
Ba _Shutters Windows/Doors
Electric M Plumbing Osprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction•. . Ft. of First Floor:
Cost of Construction: $ .2- � �� Util'ldes: Sewer Septic Building �
He ht-
OWNER/LESSEE:.
COI�TC
Name '� ^ ,,.`
Name:,d � nwt r
Address: = /—Cc�_r7-C , S a C,_/2
Company: � �,r, t` ;,, ( n E-,ne_ 77 Ycn
City: 7_ _L- n State: FL
Address: I -4 fr-
Zip Code: v( SA Fax:
City: _s C- State:_EL
Phone No. r -7 7 - n
Zip Code: 3 Y S's- S Fax.
Phone No. c-1® S- - q 7—
E-Mail:
Fill in fee simple Title Holder on next page ( N different
E-Mail: C a a CT,,
from the Owner listed above)
State or County License: G--A L
0 value of construction is $25W or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
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 an posted on the jobsite before the first inspection. If you intend to obtain financing, consult
tenth lonrinr t2ttnrnn., hrafnra rnmmonrino wnrk nr recordin€ vour Notice of Commencement.
gnature of Owner/ Lessee/Contractor as Agent for Owner
Sigfiature of Contractor/License Ho er .
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S "r L C—L i e
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
yPhysical Presence or Online Notarization
th is /72- day of 2026 by
this _1i day� sl �ca-� i - , 202# by
/of
(�J
Name of person making statement.
Name of person making statement.
Personally Known _ r/ OR Produced Identification
Personally Known 4--6R Produced Identification
Type of identification
Type of Identification
Produced
Produced
( 1gnature of Notary
(Signature of Notary P
Commission No
`���;Y,�/,, TAYLOR GAGNE
NotaryipoWlate of Florida
Commission No.
��"""'�� TAYLOR GAGNE
=r =Notary P fate of Florida
Comrriission # GG 293167
eA'' My Commission Expires
ra Commi GG 293167
0P My Commission Expires
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ZONING _
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SUPERVISOR
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VEGETATION
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MANGROVE
COUNTER
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 5/ b/ 20
Certificate of Product Ratinas
AHRI Certified Reference Number: 202717849 Date: 03-17-2021 Model Status: Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS
Outdoor Unit Model Number (Condenser or Single Package) : PA4ZNB036"
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 AHRI 210/240 with Addendum 1, 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 still
selling or offering for sale.
Ratinas that are accompanied by WAS indicate an involuntary re -rate. The new published rabno is shown along with the Drevious (i.e. WAS) 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 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; A. ■■ -'
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 betteTM
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. 132604940717350229
©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: