HomeMy WebLinkAboutbuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0WOO
V 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: 0 ? t &jjn��
Property Tax ID#: (.3 al — 7v1 lqo -O
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
�_Wechanical _Gas Tank _Gas Piping
_ Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $9 S�
_Shutters
_Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L1\jaLWO (J%
Name: flA
04r�LC /kl
o s
Address: 9 ? S AnE ptyh- _ Dr
Company: (�a v-KA� /9v'�
6011d 6 Twf Lll
City: 1'A P iC✓'(¢. Stater
Zip Code: g49 Fax:
Phone No,
Address: ) 5i 3 (o Oomph
&, 194-k-4-
City: t.)eA�o &Ae-. State:.E.0
Zip Code: 3 24 it 0 Fax: ?) a- SZo X' S 3cfy
Phone No "7 7 a SZe 2. � 1Ay •S
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail J476n ,,jz loa. kX ev:
9/�eu `I • l� c�
State or County License
p s 7 ate.
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 CONSTRUCTIONLIEN 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: C Not 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 a,9&f posted on tho site before the first inspection. If you intend to obtain financing, consult
with Loftfilpirpyan att ne or c mmencin work or recordin our Notice of Commencement.
i
Sig Ure o wner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF t]Dj�sA(Vuul?a/
SwornAo (or affirmed) and subscribed before me of / ` Physical Presence or Online Notarization
this, day of ` J( �A ul _�, 204 by
I,
Name of person making statement.
Personally Known _>5—D OR Produced Identification
Type of Identification Produced
(Signatu oI Notary/Public- State of Florida )
Commi i No. 1 (4 3 / (Seal) IENND'ERGMADOLORESCRISANiE
MY COMMISSION M HN7174
HxPiRES: Mey 25, 2024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5
Eligible for Federal Tax Credit
Certificate of Product Ratings
AHRI Certified Reference Number : 8627727 Date : 07-OB-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, MI, MN, MO, MS,
MT, NC, NO, 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 2101240 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 Ihose that an AHRI Certificallon Progmm Paricipant is currently producing AND selling or offering for sale; OR new models that are being
marketed but are not yet being produced "Production Slopped' Model Status are those that an AHRI Cedificalion Program Participant is no longer producing eU7 is still
selling or offering for sale.
RatinOs that are accompanied by WAS indicate an involunlary re-mte. The new published rating is shown along with the previous (i.e. WASI 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.ahrid lrectory.ofg.
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; A.
entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the users 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 www.ahrldlroctory.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.
02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1327o234xggsagl6n