HomeMy WebLinkAboutBuilding permit appAll APPL C BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential ✓X\
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR
I PROPOSED IMPROVEMENT LOCATION 1i I
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
p DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
cy
Cost of Construction: $A615
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWN R/LESSEE:
CONTRACTOR:
Name
Name:
�(�-
Addr s: 1
Company: k` c
5
C
City: SILL Stater
Zip Code:` Fax: ''
Phone No. tt�5-�04 - UUc �l E-
n
Address: "
�u� �``
City:�1)A1 IAA\,7('
Zip Code: al
Phone No Z' u -
Stater(
Fax. 11� i� I-3 C"�iv
hC ll
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail a
�
�(�v�
State or County Licensecy)c
`t kA Scl
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
Zip:.
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 conflicts with any, applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature f wner/ Lessee/Contractor as Agent for Owner
STATE
COUNTY OFORID l I�U��A�
rr�to (or affir ed) and subscribed bef me of
Physical Presence orOnline Notarization
day of C'� 20_4by
f�b�fi � Q(Ce]le
Name of person making statement.
Personally Known OR Produced Ident� fic1ation
�(1\)GCS �CEf14�
T::3=WAk
(Signature of Notary Public- State of Florida)
CATHE11INE MILLER
CommissionNo.fZ�vl5(Seal)
�`0� State of Florida -Notary Public
_ .= commissionMGG273315
;" My commission Expires
November01,2022
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MWA sum
Certificate of Product Ratings
AHRI Certified Reference Number: 7615302 Date: 09-13-2021 Model Status : Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Series: AIRTEMP VP7RE SERIES
Outdoor Unit Brand Name: AIRTEMP
Outdoor Unit Model Number (Condenser or Single Package) : VP7RE-042K
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 regions) for
which they meet the regional efficiency requirement.
The manufacturer of this AIRTEMP product is responsible for the rating of thissystem 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 : 40500
SEER: 14.00 -
EER (A2) - Single or High Stage (95F) : 11.00
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.
Retinas that are accompanied by WAS indicate an involunlary re -rate. The new Dublished retina is shown along with the previous (i.e. WASI ratina.
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), orthe
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at www.ahridlrectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and
As _"0F
confidential reference purposes. The contents of this Certificate may not, in whole or In part, be reproduced; copied; disseminated;
-bi sk
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.ahrldfrectory.org, click on "Verify Certificate" link
we make life beter^
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.
Oo 2021 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE NO.:
132760277567736629