HomeMy WebLinkAboutBuilding Permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �-- GOZ Permit Number:
s5y.I�l� 11�5
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) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 3 G{ �t° Z L <�e! K L L `( CAYla c l
Property Tax ID #: 3 % Z - i — �� ` QQ l� _ -7 lot No. i --
Site Plan Name:
Project Name: " k � A "
I DETAILED DESCRIPTION OF WORK:
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
Electric _ Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ L
Generator
Sq. Ft. of First Floor:
Block No.
�'P CG, (A^(E0
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height.
OWNER/LESSEE:
CONTRACTOR:
Name
Name:�i���_ In7Nrf�
J
Address: 1 3g(tZ�)(V i C 1-CM ' . _
Company: kr(ULL,
City: �� i— _ -. Stater
Zip Code: S Fax:
Phone No. -7 72-)
Address: ��
W �•
City: PS L State:
Zip Code: Fax:
Phone No Z 1 " (U45
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above
E-Mail rA
State or Count License
_
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
Name: TS
MORTGAGE COMPANY: ot Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: of Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 attornev before commencine work or record4TR-rcour Notice of Commencement.
Signature of r/ Lessee/Contractor as Agent for Owner
Signature ontractor tense Holder
STATE OF FLORI 1t
COUNTY OF �
STATE OF FLORI
COUNTY OF � � , �n
Swprn to (or affirmed) and subscribed before me of
S4n to (or affirmed) and subscribed before me of
Physical Pr enc or Online N tarization
`
ysical Pr rice or Online Notarization
this day of 202 by
this day of 202(Lby
Name of person making atement.
Name of person ma I' g sta ment.
Personally Known OR P uced identification
Personally Known Prod d Identification
Type of Identificat' n
Ty e of identifcat n
Produced
Pr uced
YP 2 'vc:a pub'.tC 1 `-�
-af� � )tary PuW,c Stale of Flor'da
(Signature a P bli lori wren rusatl
g y1Canm ss,on uG 766770(S
en rusa I
natu of Notar Itu ic- $ a r I i Dmmrssion GG 188770
'fin* fir1 Exp res 721+0 2023
aFeE rD rea 32130.r202 i
Commission No.,,�,,l}
o mis on No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
Eligible for Federal Tax Credit
Certificate of Product Ratinas
AHRI Certified Reference Number, 9426814 Date: 06-02-2021 Model Status : Active
AHRI Type : RCU-A-CB (Split System: Air-Cooied Condensing Unit, Coil with Blower)
Series: 16 SEER AC
Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS
Outdoor Unit Model Number (Condenser or Single Package) : BA16NA024*0**A*
Indoor Unit Model Number (Evaporator and/or Air Handler) : FV4CN(B,F)003L
Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, Ti TX, VA, AK, CO. CT. ID, IL,
IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, Ni 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) far
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 : 24400
SEER : 16,00
EER (A2) - Single or High Stage (951 : 13.50
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
-
Ratinos that are accomoan#ed by WAS indicate an involuntary re -rate. The new oublished ratina is shown alono with the previous fi.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.ahtidirectory.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,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at wwwr-aiiridirectory.org, click on "Verify Certificate" link we make life better -
ants 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.
@2021 Air -Conditioning, Heating, and Refrigeration Institute