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HomeMy WebLinkAboutpermit regina stAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dater Permit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Building Permit Application l Commercial Residential f PERMIT APPLICATION FOR: 04 ,o f . PROPOSED INPROVEMENT LOCATION: Address: Legal Description: Property Tax ID #: Site Plan Name: Project Name: AA�� Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: C- Lot No. Block No. CONSTRUCTION INFORMATION: itiona wor to e pe orme un er t is permit— c ec a t at app y: Gas Piping Shutters _ Windows/Doors _Mechanical _Gas Tank — p g — _ Electric — Plumbing — Sprinklers — Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: — / Cost of Construction: $ ,-d—L 1 Utilities: _ Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name: Name d Company: Addres • _ cra+P f Address S r City: Zip Code: �? Fax: Phone No�, E-Mail:' Fill in fee simple Title Holder on next page ( if different from the owner listed above) '• State or • if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Not Applicable SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION' ORTGAGE COMPANY: DESIGNER/ENGINEER: Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:. Not Applicable State: Not Applicable M Name: Address: City: Zip: �—Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: State: _ Not Applicable 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before cnmmPncine work or recording vour Notice of Commencement. Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF G rnt tuClG COUNTY OF SG '1-74 Lu Ci f The forgoing instrument was acknowledged before me this 1 day of iyl =- y 20 Z t1 by The forgoing instru ent was acknowledged before me this r / day of m �+U 20A) by , �J u�� /mot (Name of person acknowle i �'� � .� Notary Public State of Florida (Name of person acknowledgin tChristine Holland p� My Commission GG 326704 Da✓<• Notary Public State Of Florida Christine Holland T y� Expires 04/22/2023o: A" : * My Commission GG 326704O Expires 04/22/2023 Signature of Notary Public- State of Florida) (ig ure of Notary Public- Sta f� Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. �.� 0 -/(Seal) Commission No. "G -3 ILLO /0y (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED CV. //LulY ti■ma/CERTIFIED` www.ahridiiectol'y.org 'Ask Ah 40 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between 1/1/2015 and 12/31/2020. Product Ratings AHRI Certified Reference Number: 8627727 Date : 02-12-2021 Model Status : Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series : XR16 Outdoor Unit Brand Name : TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TTR6036J1 Indoor Unit Model Number (Evaporator and/or Air Handler) : TEM6AOC36H31+TDR 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, 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 TRANE 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 : 16.50 EER (A2) - Single or High Stage (95F) : 14.00 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 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. Ratiigs that are accompanied by WAS indicate an involuntary re -rate The new published rating is shown along with the previou_s_(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; entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, AIR-CONDITIONING. HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION 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. 132576091259934915 ©2021 Air -Conditioning, Heating, and Refrigeration Institute f CERTIFICATE NO.: