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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F Date: JC__ /0 - .1 Build! Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 APPLICATION TO BE ACCEPTED Permit Number: Permit Application Commercial Residential 71'' PERMIT APPLICATION FOR: To Select fi om dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATIQN.. Address: Legal Description: Property Tax ID #: M - v ,p Lot Na. Site Plan Name: Block No. Project Name: ght Side: Left Side: Setbacks Front Back: R -DETAILED DESCRIPTION OF WORK; G _ 0 eONTRUCTION INFORMATION: Addifi6na1 Work to e e orme under this per 13 lt — check a apply., HVAC Gas Tank QGas !ping _ Shutters Q Windows/Doors Electric 0 Plumbing []Sprii iklers Generator Roof Roc f pitch Total Sq. Ft of construction: S . Ft. of First Floor: Cost of Construction: $ .2 �rC>E�) Utilities: Sewer©Septic Building Height: OWNER%LESSEE: COIITRACTQR: . ,. Name C << %i �G- Name: Address: Company: City: Stat : /_� Address: / � Zip Code: Fax: City: 4; C___ State: Phone No.-3—f��Z�'' Zip Code: Fax: E-Mail: Phone Fill in fee simple Title Holder on next page ( if dill rent E-Mail: 6_- Le: (! from the Owner listed above} State or County License: C_ Al, If value of construction is $25W or more, a RECORDED 0otice of Commencement is required. �E���rn�a/c�vcsirveir<R: Not Name: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Nat Name: City: - Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT :Application I certify that no work or installation has commenced St. Lucie County makes no representation that is gran; structure. Please c nsult withpyourr Home Owners Owners In consideration of the granting of this requested perr in accordance with the approved plans, the Florida Bu The following building permit applications are exempt accessory structures, swimming pools, fences, walls, si WARNING TO OWNER: Your failure to Record improvements to your property. A Notice of t before the first inspection. If you intend to of Commencing work or recording vniir Nntira n Signature of Owner/ Lessee/Contractor as Agent for STATE OF FLORIDA COUNTY OF S L The forgoing instrument was acknowledged before this > day of L , 20,E by i t P ., f MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip Phone: ble BONDING COMPANY: Not Appl Zip:: hereby made to obtain a permit to do the work and installation as in+ ior to the issuance of a permit ig a permit will authorize the permit holder to build the subject struct ssociation rules, bylaws or and covenants that may restrict or prohibit :lation and review your deed for any restrictions which may apply. t, I do hereby agree that I will, in all respects, perform the work Zing Codes and St. Lucie County Amendments. -om undergoing full concurrency review: room additions, ns, screen rooms and accessory uses to another non-residential use Notice of Commencement may result in your paying twice for )mmencement must be recorded and posted on the jobsit ain financing,; consult with lender or an attorney before Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF S The forgoing instrument was acknowledged before me this ro dayof /icy C 20 )_( by Name of person making statement Name of person making statement Personally Known OR Produced Identification'" Personally Known OR Produced ide Type of Identification Type'of Identification Produced Produced (Signature of Notary Public- State of Florida 1 Commission No. TAYLAGNE ���pftY Pp _ ry Publ to of Flc * *W Commission # GG 2931 >,9F�FF\oe My Commission Expiry _January 21, 2023 (Signature of NotaryPublic- State of Florida ) ,, St Commission No. ��^Y P�'y; TAY L 0 R y Public ate NE f Florida '' *= Commission # GG 293167 My Commission Exni,.. REVIEWS FRONT ZONING SUPE ISOR PLANS VEGETATION SEA TURTLE MANGRO E COUNTER REVIEW REVI REVIEW REVIEW REVIEW REVIEW DATE COMPLETED Rev. 8/2/17 AHRI Certified Reference Number -. 202717849 AHRI Type: SP-A (Single -Package Air -Conditioner, Air-C Outdoor Unit Brand Name: BRYANT HEATING AND CC Outdoor Unit Model Number (Condenser or Single Packi Region - All (AK, AL, AR, AZ, CA, CO, CT, I MT, NC, ND, NE, NH, NJ, NM, NV Territories) 7%1= Date: 08-10-2021 Model Status: Active NG SYSTEMS : PA4ZNB036* DE, FL, GA, HI, ID, IL, 1A, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, ', OH, OK, OR, PA, Rl, SC, SD, TN, TX, UT, VA, VT, WA, WV, Wl, WY, U-& Region Note Central air conditioners manufactu prior to January 1, 2015 are eligible to be installed in all regions until June 30, 2016- Beginning July , 2016 central air conditioners can only be installed in region(s) for which they meet the regional effidie cy requirement. aT The manufacturer of this BRYANT HEATING AND COOL Rated as follows in accordance with the latest edition of A & Air -Source Heat Pump Equipment and subject, to rating Cooling Capacity (A2) - Single or High Stage (95F), btuh: SEER - 14-00 EER (A2) -Single or High Stage (95F) :11.50 r'Activd' Model Status are those that an AHRI Certification Pro marketed but are not yet being produced.'Production Stopped' selling or offering for sale. DISCLAIMER AHRI does not endorse the pmduct(s) listed on this Certificate and the product(s) listed on this Certificate. AHRI expressly disclaims a unauthorized alteration of data listed on this Certificate. Certified i directory at www.ahri d hectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products OtAHRI.- confidential reference purposes. The contents of this, Certificate in entered into a computer database, or otherwise utilized, in any for personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can he venfi and enter the AHRI Certified Reference Number and the date on w which is listed above, and the Certificate No., which is listed at hot @2021 Air -Conditioning Heating, and Refrigeratir: SYSTEMS product is responsible for the rating of this system combination. 210/240 with Addendum 1, Performance Rating of Unitary Air -Conditioning iracy by AHRI-sponsored, independent, third party testing: 00 'anticipant is currently producing AND selling or offering for sale, OR new models that are being Status are those that an AHRI Certification Program Participant is no longer producing BUT s still ; no representations, warranties or guaranteesas to, and assumes no responsibility ft ity for damages of any kind arising out of the use or performance of the product(s), or are valid only for models and configurations listed in the s Certificate shall only be used for individual, personal and not, in whole or in part, be reproduced; copied; disseminated; or manner or by any means, except for the user's individual, A7IR-00N0tT10N41NG,, HE NG, I Tl 1 14 " & REFRIGERATION MST E it_ I at www.ahridirettory.org, click on 'Verify Certificate' link we MA-e lifo betu'r, ,t the certificate was issued, ;7 n right. Institute CER11FICATE NO.: 132731;04159873 53�6