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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABL INFO MUST BE COMPLETED FOR APPLICATION Date. TO BE ACCEPTED �' Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial P E R M IT TY P E: k �� ply;,, I'd } L GU C:Z---- PROPOSED IMPR Address: Property Tax ID #: Site Plan Name - Project Name: A MENT4LOC�TION: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Aal work to be performed under this permit — check all that apply: dditimechanical _ Gas Tank —Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: -� � Sq. Ft. of First Floor: _ (i5< cost of Construction: $ ti�_1- �� Utilities: —Sewer —Septic Lot No. Block No. Windows/Doors Roof Pitch Building Height: OWNER/ ESSEE: CONTR. CTOR: Name t Name: t t _ -� Addr s: � Company: v City: .� State: _ Addr GVAz State: Zip Code: Fax: City: �t Phone No C� 45 Zip Code: Fax. Phone N E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mai from the Owner listed above) State or unty License,__ �— If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ::�q DESIGNER/ENGINEER: — Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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 insiaiiation as m61LdLUu' 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 firsi*anspecti . If you intend to obtain financing, consult with lender or an attorney before commenein� work or rreording your Notice of Commencement Owner/ Agent/ Lessee STATE OF FLORIDA COUNTY OF L-J6 The forgoing instrument was acknowledged before me this ) day of JJ(�4 , 20by 0en0'1S CvC�'►i'-) (Name of person acknowledging ) (Signature of ry ubbllic- State of Florida ) Personally Known ✓ OR Produced fi a i Type of Identification Produced +do�a,v�a;aic.si /License Holder STATE OF FLORIDA COUNTY OF_ - t/-\ .A La.IC I Q_ The forgoing instrument was acknowledged before me this )l3 day of C% 20A by 0eI'\0t5 C0e0k� (Name of person acknowledging ) (Signatur 4Kno Public- State of Florida ) Personall1// OR Produced Identification e o tification Produced_ Urania Ganas i \ l l N ( I invCommission WtMnssio No. 1rt 1, ip'�` e YPubNcStateofF ' Commission No. niaGanes N pires 05/06/20 5 f My Commission HH 12715 Expires 05MW025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Eligible for Federal Tax Credit fs CERTIFIE , www.aliri(Iirevtory.org Certificate of Product Ratings AHRI Certified Reference Number : 8704409 Date : 07-12-2021 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) : TEM6AOB3OH21+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, 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 : 34000 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 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 prod uced."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) 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 CONDITIONSANN This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and in part, be reproduced; copied; disseminated; RMEM confidential reference purposes. The contents of this Certificate may not, in whole or 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. -- - 132706068191766816 ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: