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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - - Z Permit Number: goo LLcvi Coy, � ,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 CBDG Funding PERMIT APPLICATION FOR: L PROPOSED IMPROVEMENT LOCATION: Address: "S,/, 4/ rr-'j�� Property Tax ID #: _ �,�, 3 - �p� - �p a - dyg - 3� Lot No. / Site Plan Names �i- Block No. 6L Project Name: LL�/ d DETAILED DESCRIPTION OF WORK: T MGt. h- 14 AC e New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: (Affidavit required) Additiona�rk to be performed under this permit- check all that apply: _Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ .'Ia Q01':10 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name: Name L Address: A 3�- !�� TS . Y, , > > Company: _lct cr r e, Ld i S �- k� City: P�2 L&L 4c, Stater Address:2 Zip Code: -� Se�Q 6 Fax: City:c 6-" State: // Phone No. 2 - '3 2- 5- - i 7S— E- Zip Code: 7 Fax: Mail: Phone No 7, 1- c3 cif - .3, �1 / Fill in fee simple Title Holder on next page (if different E-Mail iC S /i n ��; •�Q,r1 from the Owner listed above) State or County Licens C ( lc 7 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 CONSTRUCTIO N LAW INFORMATION: DESlGNERjENGlNEER Name: _Not Appll ac b elel Address: City: `p'Stat -----__ Phone e' -----_ -TEE—Si MP�LE TITLE HOLDER; '- Name: � Not Applicable Address: City: Zip' ----__ Phone: MORTGAGE COMPANY: I --- Name: = Not Applicable Address: ---' City: Zlp' Phone: State: BONDING COMPANY: Name: =Not Applicable Address: City: Zi OWNER/ CONTRACTOR AFFIDVlT: Application is h made to obtainPhone: f certify that no work or installation has commenced prior to the issuance of a w Lucie Count makes no representation that is grantinga permit to do the work and installation as indicated. permit. which is in con lict with any applicable Home Owners Association rules, bylaws or and covens structure. Please consult with your Home Owners Association and review your deed for any ants restrictions permit will authorize the ermit holder to build the subject structure In consideration of the granting of this requested permit, I do hereby agree that I will, r all respects, covenants that may restrict or prohibit such in accordance with the a tons which may apply, approved plans, the Florida Building Codes and 5t. Lucie Count pects The following building permit applications are exempt from undergoing a full concurrency review: perform the work accessory structures, swimmingY Amendments. pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use accessory TO room additions, OWNER; YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT TWICE FOR IMPROVEMENTS TO YOUR PROPERTY POSTED R THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTENDIN YOUR pg AND A NOTICE OF CORIRIENCEii9ENT MUST BE RECORDED AND WITH YOUR LENDER Q ���A Y BEFORE RECORD_ ING YOUR IYQTIOF COMMEN TO N AMCING, CONSULT �% , ., . --I- r MEAT. Signature of Owner Les e y v /Contractor as Agent fo caner STATE OF FLORIDA COUNTY OF The forging instrum nt was acknowledged before me this day of OC R jJp� 20 -i!� by ern Name of person makiZOcation ment. Personally Known R produced Identif Type of Identification I Signature of Contract /License Holder ISTATE OF FLORIDA COUNTY OF I The forgoing instr m n was acknowledge this day of ` before me b zoo by Name of person making st eent m nt Personally Known OR Produced Identification Type of Identification (Sig ature of Nota Public- Y State of Florida) Com issio .0 - (Sign ture of Notary ublic- State of Florida ) ;_��,�^ '^• _' •. sw_ r (Seal °tary State of Florida Corn ssion REVIEW Commission : GG 315466 Mp Lomm. -Tires r023 .=o��� �:.• KELLIE J. SWEET Notari Public h—y B Assn. .` :�' :Q State of Florida ___ _ ____ DATE SUPERVISOR COUNTER REVIEW — REVIEW ?0 �D M' Com :• cx )res PI ANS EGET��,I ' �, zozs 023 REVIEW h`0 g AJ� RECEIVED t4sh sl LETED IANGROVE REVIEW �• :�i CERTIFIED`k' www.ahridirectory.ory Certificate of Product Ratings AHRI Certified Reference Number: 201407615 Date : 09-09-2021 Model Status: Active Old AHRI Reference Number: 8631966 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: GSX14 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX140241L' Indoor Unit Model Number (Evaporator and/or Air Handier): AWUF25XX16A" Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 GOODMAN 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 : 22000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 11.50 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 spelling or offering for sale. 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 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, AM personal and confidential reference. CERTIFICATE VERIFICATION AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make file beuel ° which is listed above, and the Certificate No., which is listed at bottom right. ©2021 Air -Conditioning, Heating, and Refrigeration Institute 1 CERTIFICATF Nn - 132756729052277231