HomeMy WebLinkAboutBuilding PermitAll APP
Date:
LICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division Commercia
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1 8
Permit Number:
Building Permit Appiication
� Residential
PERMIT APPLICATION FOR:
Lecil', tv
PR.OPOS-E'D,.IMPROVEMENT'LOCATION...
Address.
Property Tax ID #:_:7,) Cj
Site Plan Name:
Project Name: �'�-f E'-1
DETAILED DE-SCRIPTIO'N OP�WORK
k
New i i l Meter Second
CONSTRUCTION I.NFOR-MATIO.N.'.
e-
1
Lot No. �.
Block No.
Additional work to be performed under this permit— check all that apply:
Mechanics! � has Tank _Gas Piping Shutters Windows/Doors Pond
Electric � Plumbing Sprinklers enera or^ Roof Pitch
Total Sq. Ft of Construction. Sq. Ft.. of First Favor;
Cost of Construction: $ Utilities: � Sewer � Septic Buildin Height.
OWNER/LESSEE:
CONTRACTOR:
Name Name:_j'� �1 Y�`C�.� �
Address: cvVocf un Company,,,,,.
City& 'AA t;l State: !=-1-- Addre s: c: �� '
Zip Code: �L Fax: City:
Phone No.:`7�
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Zip Code:
Phone N U(_'11 i
E-Mail <VL
State or County License -
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement 46
is required.
State:
Fax
7%, zt C)
ace, Lx.,I. V)09('
r
SUPPLEMENTAL C0N,'$TRU--GTION LIEN L.-A... IN7.7
FORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Anolir.;ihlp
Name:
Address:
City: State:
Zip. Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Name.
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
_Not Applicable
Name:
Address:
city mum
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT'.A pUcation is hereby made to obtain a permit to dathe work and installation as indicated.
I certify that no work or instailation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the PermEt holder to build the subject structure
which is in confilict 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 bounty Amendments.
4%
The following building permit applications are exempt from undergoing a full concurrency review: roam 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 RESULY IN YOUR PAYING
TWICE FOB IMPROVEMENTS TO YOUR PROPERTY. !A NOTiCE CF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIONs IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEINCEMENT."
Signature of Owner/ Lessee/dq tractor as Agent for Owne"�r
STATE 0F FLORIDA
COUNTY OF 57' LUZ; C
The
forgoing
instrument was
acknowledged before me
this
j day
of "Su.!
20 2 c7 by
Name of person making s�atem�nt.
Personally Known
Type of Identification
Produced jML-01_
(Sig-nat
OR Produced identificatian i,
f Notary Public- State of Florida )
Commission N.
4*k��
OF
REVIEWSFRtjN_TrVj"'.&-*�,
co
DATE
RECEIVED
DATE
COMPLETED
eve
AUf1REY STllEHMER
Notary Public - State of F[on"di
Commission # G 317534
_034ational t#u'Ca 1 Q ;t
Signature of Cofitractor/License Holder
STATE OF FLORIDA
COUNTY OF eL--,
the forgoing instrument was acknowledged before me
this 14 day of � � �.� 3 �.� ZQ 2 � by
0^41.d Ck,
Name of person making statement. �
Personally Known OR Produced Identification
Type of Identification
Produced E L D. L
(Signature of,
otary Public- State of Florida }
Commission No. 66
PLANS
REVIEW
E ETA13
REVIEW
%Mplo 1-1 R_
AU r
Notary Public •State of Florida
s
Commission 44
tSL
jr 69.
National ory Assn
REVIEW
REVIEW
VE
Certificate of Product FZatinas
A 1 1 Certified Deference Number: 24-
Date : -21-2 21
AHRI Type : C ^A-C (Split System-, Air -Cooled Condensing Unit, Coil with Blower
Series: 14 SEER AC
Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS
Outdoor Unit Model Number (Condenser or Single Package) : Al NA *** *
Indoor Unit Model Number (Evaporator and/or Air Handler) : FB4CNP060L
Model l Status : Active
Region: Southeast and North AL, AID, DC, IDE, FL, GA, H1, KY, LA, IVID, MS, NC, OK5 SC TN TX VA, AK COY CTI�I
!A. IN,KS, MA, ME, MI, MNIM ,f T, ND,NE, NH,NJ, NY, H2Off,P ■RIiSD,UT, T,ll ,WV;Il l■WY U.S.
I I f I I
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 re ion for
which they meet the regional efficiency requirement.
The manufacturer of this BRYANT HEATING G AND COOLING SYSTEMS product is responsible for the rating f this system combination.
Rated as follows in
accordance with the latest edition of A1- RI 210/240 with Addendum 1,
Performance
Rating of UnitaryAir-Conditioning
Aar -Source Heat
Pump Equipment and subject to rating accuracy by AH I -sponsored,
independent,
third party testing:
Cooling Capacity A2 - Single or l'--iigb Stage F } btu : 56000
SEER : 14-00
EER (A2) -Single or High Stage (95F) : 11,50
`IActive" Model Status are these that an AH I Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being
marketed eted but are not yet being produced."Production Stopped" Model Status are those that an AH I Certification Program Participant is no longer producing BUT is still
llin or offering for sale.
Rahn that are accompanied bVWASIndicate an involu nta re -rate. The new ublished r tin i hewn i n ritb tie Previous.i.t .1 ASratino.
DISCLAIMER
HRI does not endorse theproduct(s) listed on this certificate and rakes no representations, warranties or guarantees as to, and assunies no responsibility for
the product(s) listed on this Certificate. AHRI expressly disclaims all liability ility for damages of any kind arising out of the use or performance of the p r duct 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.ahrid'irectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRL 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; dis erninated;
entered into a computer database; or otherwise utilized, in any form or manner or by any rears, except for the user's individual,
personal and confidential reference.
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ab rlcllr for .or , click on "Verify certificate" link
and eater 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.
Ulm.
i , ks
AIR-CONDITIONINGt HEATING,
REFRIGERATIONINSTITUTE
we make life etteral?,
@2021 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE NO.:
132687674836418707