HomeMy WebLinkAboutFORNAROL PERMIT APP completealC l%Ymp out
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
PROPOSED IMPROVEMENT LOCATION: /J
Address: so'g 1 N
Property Tax ID #: /4/L-/— (Ql Z - t7 l(7D 02Td - Ali Lot No.
Site Plan Name: Block No.
Project Name: f:F7IZA&(.1D-stdeklQe Fe- dhaiv 2 00/
DETAILED DESCRIPTION OF WORK:
s1 e 0 U -{ , 5 o n / 3 a C E A tc
ID,ect- arm, - no l oc-i wa,,-k /—' ke moo. /,l'kf
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 _ Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 86co , 00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name y\OI r O
Name: SOYf ✓
(O�
Address: � I P FE%'yujAN
kf-A i�iz-Z
Company: r'0✓
✓OL7
City: R- 4F j 2 rc 2 State: fl,
Zip Code: Fax:
Phone No. (a it) - E-
Address: J0S
City: Ek-- 10 vc e
Zip Code: 2� Q-1 Fax:
Phone No -77-- -
State: �-
ZZ%
Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mall-Lb r co, Mai
iRowckcst
State or County License iii
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.
Name;
Address:
City: State:
ZIP: Phone
FEE SIMPLE TITLEHOLDER:—NotAppifcable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: —Not Applicable
Name:
Address -
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
Zip: Phone:
CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and Installation as indicated.
t no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no reppresentation that is ggrantingg �a permit will authorize the permit holder to build the subject structure
which conflicts with any appticabie Ham eownersAssodatlan 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 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,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentlal use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your properly. 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 IpnRpr nr an attnrnev before commencine work or recording vour Notice of Commencement.
�XJlf/
Signature ofOwLessee/Contractor asAgentforowner
STATE OF FLORIDA
COUNTYOF MI)ge
Sworn o (or affir edJ anpf �P� cdbed before me of X
() 20orb
Physical Presence or —Online Notarization
this dayof
Owned womn
Name of person making statement.
t
Personally Known x OR Produced identification —
Ty Identifica a Produced
taryPublic -State of ?;' ,.•
FARSORignatu
214
•`
= MYCOMMYAN#=EEoi1
Commi U (Seal) P; E(PM:NovemberE,2024
e+
BorAWTIwNota,Y PublfeUWa
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
,
RECEIVED
DATE
COMPLETED
Rev5/1U/21
Certificate of Product Rati
AHRI Certified Reference Number: 6677925 Date 10-11-2021 Model Status: Discontinued
Old AHRI Reference Number
Product : Water -to -Air and Brine4o-Air
Model Number : SV041-1VT/CF'= ^P'A
Brand Name : BOSCH-GEO
Rated as follows In accordance with the latest edition of ANSIIAHRIIASHRAE/ISO 13256-1 Water -source heat pumps -- Testing and rating
for performance— Part 1: Water4oalr and Brine -to -air heat pumps and subject to rating accuracy by AHRI-sponsored, independent,
third party testing:
Air Flow Rate - Cooling:
Air Flow Rate - Healing:
WLHP (Water -Loop Heat Pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuhhvad)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating Cop (watdwen)
Healing Fluid Flow Rate (gpm)
GLHP (Ground 400p Heat Pumps)
Cooling Capacity (Btuh)
Cooling EER Raring (BtuhlWaft)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating COP (wattlwan)
Heating Fluid Flow Rate (gpm)
Indoor Blower Motor Fan Type : PSC
Sold In? : USA
Full Load Part Loadi PartLoad2 Part Load3
1200
1200
39500/39500
13.60/13.60
9.00
44600144600
4.20/4.20
9.00
41200/41200
15.60/15.60
9.00
2940029400
3.3013.30
9.00
Whom rating shows valueNalue. the first value is at minimum voltagethe second value is at 230v for a dual von system.
*Models with -Discontinued' Model Status ens those that an AHRI Certification Program Pamcipant no longer produces AND is no longer selling or offering for cab
�unes the .r. e�mnonied by WAS inelol..n mvewnlary r..ole. The new eunLahetl rauna re ahpwn along wile Ina prewous n �. WASI nbm.
DISCLAIMER
AMwI does nad enaem me pock al nN.e an this W runeete aria m.koo n r.p.e.e^uuan.. w iron.. or ... e. le, it" ea.umM ne .wpenelnmry ro..
the produalul noted on mr pnmeeu. ANeI .eorwrr d.—Wms .0 nebuer I., d.m.a.. of snv hind erbinlIl1 r ar �n ouq or perlormenae al the pooh 1. er me
nit thodred onerous. M dale noted on this Grttfiub. Certified nlln0.1. re1W only for med.l0 and oonbaumu.. Ibled In tb.
dlm= at www.ahrlElraelory.ora.
TERMS AND CONDITIONS �.
This Certificate and Has contents am prapristary pmdu=of AHRL This Certlffonts shall only be wed for Individual. personal and
confidential reference purposes. The contents of this Certificate may not, In whole of In part, be reproduced; copleC dissemrnaled. AF``Aiiyi Maw %a sla
entered Into a computer database; or otherwise utp!zed, In any f)rm or manner or by any means, except for the usei s -
personal and confidential reference
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at anew.ahrldirectory.orgr ckk on'Varlly Certificate' link
and enter the AHRI Certified Reference Number and the date on which the certificate wall lesuadr
which is listed above. and the Certificate No., which is listed at bottom right.
02M1Atr-Conditioning, Heating. and Refrigeration Institute CERTIFICATE NO..
.,, M..
132784412508176259