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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR Date: APPLICATION TO BE ACCEPTED `-tr - % 3 .- �� Permit Number• ------------- I 9ji ft planning and fleve/opmentServices Building Permit Application Building and Code Regulation Division 2300 WrginiaAvenue, Fort pierce FL 349a2 Phone: (772) 462-1553 Fax: (772) 462_1578 Commercial Residential ?'RUCTtON tNF(}RMATLDN:.. i rona .wo to e^ r-�rr �e I'm un er Es norm ,r-�-nvF►L tjGas Tank "Gas Piping IjElectric ❑ PI �....1 . S c_ Ma apply: _ Ij �rs Windows/Coors umbing Spnniders Generator U Roof �_J Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ _ d- Utilities: Sewer Septic Building Height: OWNERJLE -S CQ i�� TQl2 Name S ,-. c--- Name: Address. C Int'n Company: L� o C�' , C ,--. City: _� Add -� n Zip State: Address: � Code: 7 Fax: r— • -� �-/ S'. � City: _f � S L State:LC Phone No. > 3 �' f - 5' Z Zip Code• • Fax: E-Mail _S `-� ,� c „ „ � I � '' �-/ _� L Phone No. ��.p �--t F-3-T— Fill in fee simple Title Holder on next page ( If different E-Mail: L �. f _ from the Owner listed above) � State or county license: A F i -F- V -7 If value of construction is $2500 or more, a RECORDED Notke of Commencement is 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: TNot 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. 1 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- a attornev before commencine work or recordine vour Notice of Commencement. Signature er Lessee/Contractor as Agent for Owner Sig ature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA __ COUNTY OF S % Lam,` COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of ,Physical Presence or Online Notarization Cal Presence or Online Notarization this /-& day of f!yo 2020 by this / Z day of 202P by Name of person making statement. Name of person making statement. Personally Known e/ OR Produced Identification Personally Known -- 011 Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida) (Signature of Iota Public- State of Florida ,.t,`R�J d�'! TAY L O R k� N E Commission NO ; o ��"fY public-Stt(( f Florida ���'pPY P!!� TAY L OAG N E , COmmI5510n No. . 4 ry Publi of Florida y Commission # GG 293167 + Commission # GG 293167 ;�,' M Commission January 21, 204�41SOR "+u+++'` January 21, 2023 REVIEWS PLANS VEGE E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 576720 •+:�.�i CERTIFIED° www.ahridirectory.orgCertificate of Product Ratinas AHRI Certified Reference Number: 203360799 Date: 04-13-2021 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: WEATHERKING Outdoor Unit Model Number (Condenser or Single Package) : WA1424CJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : WH1 P2417STAN 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, Wl, 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 WEATHERKING 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 : 22800 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. Ratings that are accompanied by WAS indicate an involuntary re -rate The new published rating is shown alona with the previous -(Le. 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; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AM 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 and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, we make life Fetter which is listed above, and the Certificate No., which is listed at bottom right. ©2021 Air -Conditioning, Heating, and Refrigeration Institute s CER"nFIC ►TE NO.. 13 7837 512411