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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPlanning and Development Services Building and Code Regulation Division Commercial_ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: All APPLI B E I MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L- Permit Number: Building Permit Application Residential J New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional workto be performed underthis permit -check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Electric _Plumbing _Sprinklers Total Sq. Ft of Construction: C' Cost of Construction: $ 1 Q Generator Sq. Ft. of First Floor: Lot No. Windows/Doors _Pond Roof Pitch Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Z' Name: `c Addrs`: �S C 5 City: CV CC, Stater Zip Code: �t4 C `D -17 Fax: ��� Phone No. 1U zz %' ��y Jy E- Company: JLa � Address: SUP t �(��f' (� nS� D(.vZz�5 City�lWA sc (y'* Zip Code: � i 16\-0 Phone No'i'1Z''5 ' U State: Fax: l-)Z 1 S_ 300V Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail Q I-Q( cC e'y m (C-1j� � i,- L xn imiol State or County LlCenseCfl C— I'v 51 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: DESIGNER/ENGINEER: _ Not Applicable 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. 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 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 attornev before commencing work or recording your Notice of Commencement. Signature of Owqerf Lessee/Contractor as Agent for Owner STATE OF FLORIDA�\ I COUNTY OF A Sworn (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 3e0[e 3 , 2o2Aby — Name of person making statement. Personally Known OR oduced,(d�ific tion Type, of ldent ficattiio/n /Pr/odnuce'd (Signature of Notary Public- State of Florida ,��;; �,,, CATHERINE MILLER 213 1 °ti? State of Florida -Notary Public Commission No. (seal) commission # GG 273316 °i�m�`�, MNov mber 01. ommission 2022es REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/2 Certificate of Product Ratinqs AHRI Certified Reference Number: 205725735 Date: 09-29-2021 Model Status : Active AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled) Outdoor Unit Brand Name: WEATHERKING Outdoor Unit Model Number (Condenser or Single Package) : WSPM-A036J Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, It, 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 WEATHERKING product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 2101240 with Addendum 1, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third parry testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 35000 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 amomDanied by WAS indicate an involunlary re -rate. The new Dublishad retire is shown along with the Drevious (i.e. WAS) ratine. DISCLAIMER AHRI does not endorse the products) 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, 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.ahridirectory.org, click on "Verify Certificate" link wo enaku lile 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. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132773999864306476