HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INF9 MUST BE COMPLETFD FOR APPLICATION TD BE ACCEPTED
Date: (z 1 Ds I Permit Number:
SM
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1579
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PERMIT APPLICATION FOR: aa e ou.
PROPOSED IMPROVEMENT LOCATION:
Address: �a Dt{ vIif�_L 3� S
Property Tax ID #: 3 0 a ('o ❑0(o -a 000 + g Lot No.
Site Plan Name: Block No.
Project Name: -to Lo
DETAILED DESCRIPTION OF WORK:
e ` r Con % •V i
e' 5 r
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 T Pond
Electric Plumbing Sprinklers Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ _ ` J ' � utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name �7f'gG�- ; �+'� il-3 Name: 1 !S k) 1 ekp 1 S
Address: iP i a1-Company:S Q-t& rd ktkon\V) Vviv i C-o--
city: } . r State: L Address: tM- Ow hUCqn+'&'e' ll
Zip Code: �� Fax: City: StateTR
Phone No._ �g - `� ya Zip Cade: 349 $(v fax: 7a- - 35 i 1
E-Mail: Phone No `n 2.-- T1 ! 5C-0
Fill in fee simple Title Holder on next page (if different E-MailL- CAD")
from the Owner listed above) State or County License�►-3�-.--
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.
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:
^ 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 ao the worK an❑ 1rMaiidUiUrl as Irlu]C@LV".
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
structure. conflict
jsult w thpyourHlome Owners Associationtion and review your deed far any restrictions which may apply ibit such
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 p ted on the jobsite before the first inspection. If t d to obtain financing, consult
with lend me before commencin work or recordin ur No i of Commencement.
4
Signature of ❑ ner see/ ontractor as Agent for Owner Signature of C ra or/ cen Holder
STATE OF FLORI A ot� ��- i �C1lQ COUNTY OSTATE OF RQRi f �] LV �lr
COUNTY Of
Sworn to (or affirmed) and subscribed before me of
- Physical Presence or online Notarization
this .5 day of G-MC 2021 by
Name of person making statement.
Personally Known �_ OR Produced Identification
Type of identification
Produced
(Signature of NotaryP�--
7NCommission No. 339871
�„ Expires e}5129*023
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
�( Physical Pr es ce or online Notarization
this S day of CV . 2021 by
�Toc , c. � i ch. o f
Name of person making statement.
Personally Known V' OR Produced Identification
Type of identification
Produce,1-
(Signature of Notary I �i77""rraPFr,.,.�_,.
Notwy PuW Slate o! Florida
JennifEr I ui
Commission No MyCornmi 339671
y„ Expires $S/2912023
RVNING SUPERVISEVIEW REVIEWDR RE VIEW VEGETATION
S REV EWLE REVI WVE
This combination qualifies for a Federal Energy Efficiency Tax Credit when
Ir placed in service between 1 /1 /2015 and 12I3112020.
CERTIFIED
C�
rtif i bate of Product Ratingsmoommommo�
AHRI Certified Reference Number : 202544188 Date : 03-05-2021 Model Status: Active
AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coll with Blower)
Series : GSX16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX160371A`
Indoor U n i I Model Number (Evaporator and/or Air Handler) : AVPTC37C14B"
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, Ml, MN, MO, MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, ON, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, Wl, WY, U.S.
Territories)
Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed in al regions
until June 30, 2016, Beginning July 1, 2016 central air conditioners can only be installed in regi0n(s) for
which they meet the regional efficiency requirement.
The manufacturer of this GOODMAN product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHRI 2101240 with Addendum 1, Performance Rating of Unitary Air -Conditioning
& Air -Source Heat Pump Equiprnent and subject to rating accuracy by AHRI sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or Nigh Stage (135F), btu : 35000
SEER: 16,017
EER (A2) - Single or High Stage (95F) : 13.00
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
ma"led 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 reviaus Far safe.
i e. WAS n
Ratings that are ac m anied I) WAS indi a an invol nt re-ra The new ublishe r in is show n with .
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 IN Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the prod uct(5), 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 ceruiflcate may not, in whole or in part, be reproduced; copied; disseminated: �. On ad
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. AFREFRIGE IaTIN N INSTITUTE
CERTIFICATE VERIFICATION & REFRIGERATION INSTrflrlE
The information for the model cited an this certificate can be verified at www.aIt rid Irecto ry.org, click on "Verify Certificate" link we matte life better"
and enter the AHRI Certified Reference NItmher and the date on which the certificate was issaed,
which is listed above, and the Certificate No., which is listed at bottom right.
02021 Air -Conditioning, Heating, and Refrigeration Institute � CERTIFICATE NO.: 132594b2U486614775
Michelle Franklin, CFA— Saint Lucie County Property Appraiser --All rights reserved.
Property Identification
Site Address: 6104 BIRCH DR
Seee rown/Range: 11136&40E
Parcel 11): 3402-609-0622-000-8
Jurisdiction: Saint Lucie County
Ownership
Grace Y Benway (LF EST)
PO Box 12667
Fort Pierce, FL 34979
Legal Description
1NDIAN RIVER ESTATES-UNIT-08- BLK 69 LOT 16 (MAP 34/1 IS)
(OR 875-837: 2399-384)
Current Values
JustlM arket Value:
$153,600
Assessed Value:
$74,998
Exemptions:
$50398
Taxable Value:
$24,500
Property taxes are subject to change upon
change of ownership.
■ Past taxes are not a reliable projection of future
taxes.
■ The sale of a property will prompt the removal or
all exemptions, assessment caps, and special
classifications.
Taxes for this parcel: SLC Tax Collector's Office
Download TRIM for this parcel: Down Ioad PDF
Use Type: 0100
Account 4: 38113
Map ID: 34/1IS
Zoning: RS-4 Count
Total Areas
Finished/Under Air (SF): 1,452
Gross Sketched Area (SF): 2,628
Land Size (acres): 0.23
Land Size (SF): 10,000
Building Design Wind
Speed
Occupancy Category I Ill III & IV
Speed 140 160 170
Sources1inks:
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
C Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved.