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HomeMy WebLinkAboutBUUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a";i�-� Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _ PERMIT APPLICATION FOR: ����, �i��_ PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: Property Tax ID #: Site Plan Name: Project Name: -4 Setbacks Front Back: Right Side Left Side: Lot No._ Block No. DETAILED DESCRIPTION OF WORK: - _ . - - I -I _ __ -A � Imo. I i . i — . - - „: - t -.7 i `_;_ . A_ . , h i CONSTRUCTION INFORMATION: Additional work to be pertormed under this permit - check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $) Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: Name Addre City: State: Zip Code: "31-AFax: Phone No 73 W E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) MOM FIRMA JF MINA If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 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: 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. 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM ENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF W "C STATE OF FLORIDA COUNTY OF ("6 e-- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this PS day of 20�2 by this G> day of '0)0l=q 20 A by oe/Nn,k CST-c Den I-) CVeSkG Name of person makingstatement. Name of person making statement. Personally Known ✓/ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced sv o (Signature of Not P lic- State of FI i�1e� f Urania Ganes ,,``�� MY COMMasion Commission No. {i1j i�� I�3 (S2£t `� Eon �Signatur of No ry ublic- h r�� H 27i 53 HH 127153 s i No.y`a� Ex o5roet2o25 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE 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 : 10093674 Date : 07-14-2021 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) : 4TTR6042J1 Indoor Unit Model Number (Evaporator and/or Air Handler) : TAM9AOC42V41 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, 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 : 41000 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. Ratings that are accompanied by WAS indicate an involuntary re -rate. The new published rating is shown along with the previous (i.e. WAS) ratino. 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 "ED' 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 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. _ — --- -- ©2021 Air -Conditioning, Heating, and Refrigeration Institute , CERTIFICATE NO.: 132707700760316759