HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F
Date:
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
PERMIT APPLICATION FOR: To Select fi om dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #: - C)- - Lot No,
Site Plan Name: Block No. J—
Project Name:
Setbacks Front Back: R ght Side: Left Side:
DETAILEQ DESCRIPTIONOF WORK:
f CC)Cr—
CONSTRUCTION INFORMATION
AdditISA51 work to e e orme under this pe it - c ec a apply:
HVAC Gas Tank ❑Gas iping _Shutters Windows/Doors
Electric 0 Plumbing FISpri klers Generator Roof Roof pitch
Total Sq. Ft of construction:
Cost of Construction: $
S . Ft- of First Floor: _
Utilities: Sewer a Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: � S .�,- �`
city: S L. Stag
Zip ode: 3 / 5—.2 Fax:
f
Company:
Address:L
City: L State:�Gs
Phone No.P -
Zip Code: 3 V Fax:
E-Mai1: c L c,—e `
Phone No. Cl)
Fill in fee simple Title Holder on next page ( if diffe
rent
E-Mail: too
from the Owner listed above)
State or County License: f-f _Y- y
t, valuc yr cvnssrucaon is ,,;,cauu or more, a KtuuKutu !Notice or commencement is required.
SUPPLEMENTAL CQNSTtUCT1C}Pj
r. �.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ____ Not Applicabi
Name:
Name:
Address:
City: State:
Address:
City: State:_
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Appli
cable
BONDING COMPANY: —Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip:'. Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application
s hereby made to obtain a permit to do the work and installation as inc
icated.
1 certify that no work or installation has commenced
rior to the issuance of a permit.
St. Lucie County makes no representation that is gran
which is in conflict with any applicable Home Owners
ng a permit will authorize the permit holder to build the subject struct
ociation rules, bylaws or and covenants that may restrict or prohibit
re
such
structure. Please consult with your Home Owners Ass
iation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested per
it, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Bu
ding Codes and St. Lucie County Amendments.
The following building permit applications are exempt
accessory structures, swimming pools, fences, walls, s
from undergoing`a full concurrency review: room additions,
gns, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Recordt.11
Notice of Commencement may result in your paying twice for
improvements to your property. A Notice ofmmencement
must be recorded and posted on the jobsi
e
before the first inspection. if you intend to oain
financing,:, consult with lender or an attorney before
„__ Y -}
commencen woricur reLUiun► vu1 1VVL14.1U
L..,.,....�.........--
ignature of Owner/ Lessee/Contractor as Agent for
Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF C_ -
COUNTY OF S
ne
The forgoing instrument was acknowledged before i
The forgoing instrument was acknowledged before me
this ',?- c�- day of % u- 20L1 [ by
this 3 day of Ac� C , 20� by
L
Name of person making statement
Name of person making statement
Personally Known OR Produced identification
Personally Known OR Produced Identificat
n
Type of Identification
Type, of Identification
Produced
TAYLOR GAGNETAYLOR
Produceqof
GAGNE
Public -State of Florida
o,� Notary Public -State of Florida:.Notary
*= Commission # GG 293167Commission
# GG 293167
, Q; M Commission Expires(Signatur
Publid�SCat of ,Ffor- a(Signat
-
Commission No. (Seal)
Commission No. (Seal)
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ERVISOR
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
AHRI Certified Reference Number: 204005871
AHRI Type: SP-A (Single -Package Air -Conditioner, Air-C
Series: FRIGIDAIRE P7RE SERIES
Outdoor Unit Brand Name: FRIGIDAIRE
Outdoor Unit Model Number (Condenser or Single Packs
Region : All (AK, AL, AR, AZ, CA, CO, CT, I
MT, NC, ND, NE, NH, NJ, NM, NV
Territories)
rM � � ZM �, � 4 1 i Li 1 .7,
Date: 08-30-2021
):P7RE-048KA
Model Status: Active
DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS,
, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S.
Region Note : Central air conditioners manufactur id 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 efficie icy requirement.
The manufacturer of this FRIGIDAIRE product is responsil le for the rating of this system combination.
Rated as follows in accordance with the latest edition of A RI 210/240 with Addendum 1, Performance Rating of Unitary Air -Conditioning
& Air -Source Heat Pump Equipment and subject to rating ccuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) -Single or High Stage (95F), btuh 6500
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.00
t"Active" Model Status are those that an AHRI Certification Prc
marketed but are not yet being produced."Production Stopped"
selling or offerinq for sale.
DISCLAIMER
AHRI does not endorse the product(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.ahridirectory.org_
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI.
confidential reference purposes. The contents of this Certificate m
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 be verif'.
and enter the AHRI Certified Reference Number and the date on w
which is listed above, and the Certificate No., which is listed at bot
@2021 Air -Conditioning, Heating, and Refrigeratit
Participant is currently producing AND selling or offering for sale; OR new models that are b ing
I Status are those that an AHRI Certification Program Participant is no longer producing BUTI is still
,iakes no representations, warranties or guarantees as to, and assumes no responsibility fdr,
liability for damages of any kind arising out of the use or performance of the product(s), o tt
tings are valid only for models and configurations listed in the
s Certificate shall only be used for individual, personal and WWI
not, in whole or in part, be reproduced; copied; disseminated;
UE
or manner or by any means, except for the user's individual,
AIR-CONDITIONING,
& REFRIGERATION I
I at www.ahridirectory.org, click on "Verify Certificate' link Nye make life be
ch the certificate was issued,
'n right.
i Institute I CERTIFICATE NO.. 13274800475