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HomeMy WebLinkAboutpermit4 F All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Building Permit Appl*ication Planning and Development Services � Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierre FL 34982, Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding Property Tax 1D #: 4.0 4 Ch- (ao 8 V.-GjL`j Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: .y _V �� - •fir- ti�Sr� •• v $'•i' r ,� �S � t,�: .k , pU New Electrical Meter Second Electrical Meter_ � {Affidavit required} CONSTRUCTION INFORMATION: Additional work to be performed under. this permit —check III that apply: 1114ZI-Mechanical _Gas Tank � = Gas Piping � Shutters Electric Plumbing Total Sq. Ft of Construction: Cost of Construction-, $ Date. 9 Sprinklers generator Windows/Doors Roof Lod Na. Block No. Sq. fit. of First floor: Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR:. Name Name : ��L.�G'�•'U Address: Company: City: �� i�_-� � _ State: �. Address: Zip Cade: `��.q � n� Fax: City: 1:*v State: Phone No. E- Zip Code: fax: ��'�-� - AI *I Maid: '� Phone No `� � k� S; Fill in fee simple Tithe Holder on next p�je cif different E-Ma iI 10� i kAr'\ tQ�,F a3ikl C CAOV-4, from the Owner fisted above) � � State or County license If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVt is $7,500 or more, a RECORDED Notice of Commencement is required. Pond Pitch i i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. DESIGN ER/E NGI NEER-.& Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone,, dip: Phone: OWNER/CONTRA OR 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. t. Luce County makes ro re'resentation that is granting.a permit will authorize the permit holder to build the subject structure which conflicts with any app icable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners Association and review our deed for any restrictions which may apply. In c-on a derati o n of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work ire accorda nce with the approved plans, the Florida Building Codes and St. Lucie County Arnendment , The fallowing building permit applicativns are exempt from undergoing a full cancurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen roams and accessory uses to another non-residential use WA R N I N G TO OWNER; You 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. cue ounty and pasted on the job�5d'e before the first inspection. If you intend to obtain financing, consult with le der or an attorney before 6ommenun2 work or recording your Notice of Commencement. i 0, rVo� owner/ Lessee/Contractor as`Age`n��or Owner STATE OF FLORID COUNTY of T LI) C I r= Sworn to for affirmed) and subscribed before me of #his_ day of TCP�e e , 20 by NA Iz- Name of person making statement. Personally.{FrTTo" Tyke of ldentif' (Signatureb commissi REVIEWS OA Produced identification 'kd ati n Produt Notary Public- State of Florida No. (Seai) DATE RECEIVED DATE coMRLE-rEo 1W Y7, ..__ Physical Presence or Online Motorization ti • F � 1 f * + Cornmission # HK 023495 dt r • t �*Ex pires J u ly 26, 204 BaMed Thru Trq Fain Ins wince 80-M761 FRONT ZONINGI SUPERVISOR E\ COUNTER REVIEW REVIEW 0 PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW i Certifica te of Product Ratings CE Certified Reference Number - 201295489 Date : 1 0--0 1 Old AHRI Reference Number : 7984196 AHRI Type : RCIJ-A-CB (5plit System: Air -Cooed Condensing Unit, Coii with Blower) Series: GSX14 Outdoor Unit Brand Name : GOODMAN' Outdoor Emit Model Number (Condenser or Single Package) : X 140 1 * Indoor Unit Mode Number (evaporator andlorAir Handler) : ARL1F37C14A* Region : Region Dote Model Status : Active Southeast and North L, AID, DC, DE, FL, GA, H 1 x KY, LAB, MD, CIS, IBC, � SC, TN, TX, VA. ABC, GO, CTI ID, 1 L} I , ll ,IDS, MAr ME] I'll, MN, ,CIO, MT, ND, NE, NIA, NJ, NY, H� OR, P , ICI, SID, LJT3 .? WA, } Wl, Wy, U.S. Te rritori 'I oritral air conditioners manufactured prior to January 1, 2015 are eligibleellgible to be installed in all regions until June 30, 2016. Beginning July 1, 2016 central air candItioners can only be installed in re ion( ) for which they meet the regional efficiency requirement. The manufacturer of this DMAN product is responsible for the rating of this system combination. Rated as followsfoilows in accordance with the latest edition of AHEM 10/ 40 with Addendum 1, Performance Rating of Unitary Air- and*ltionin Air -Source Feat lump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party tasting: Cooling Capacity (A - Single or High Stage (95F), btuh :33600 _. SEER. 14.00 EER (A2) -Single or High Stage (95F) : 11.50 &'ss'eis�ipa t"Activei7 Model Status are those that an AHRI I rtifi tion Program Participant is currently producing AND selling or offering for sa[e; OR new models that are being arKeted but are not yet being prod uced.=Production Stopped" Model Statu3 arc tho5t� that Fars AHEM Certification Program Participant 13 no longor prodQclnq BUT i5 still sell Re-,ing or cffering for sale. rr� that are accompanied WAS 'Indicate an involuntary re -rate. The newPublished ratin i shown aler� with the re�rE�u i.e.1 A rati n . DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and rakes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(listed on this Certiftate. AHRI expressly disda i r s all lia bllity for damages of any kind arising out of the use or performance of the pr-od uct(s)f or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the d [rectory at www.a Find i rectory*or. TERMS AND CONDITIONS This Certificate and its cuntents are proprietary products of AI- RL This Certificate shall only be used fir individual. personal and conTidential reference purposes. The contests of this Certificate may not, in whole or in part, be reproduced: copied: disseminated; entered irite a computer database* or otherwise utilized, in a ny form or manner or by any means, except for the user"s -1ndi ideal, pvrvc-rrzaI and c�<Pnfidiaritio1 CERTIFICATE VERIFICATION The Way nation for the model cited are this certificate can be verified at www.ahridire for .or f click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above. and the Certificate o_, which is 1 ist d at bottom right. 42021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: AIR-CONDITIONING. WFATIN . & REFRIGERATION INSTITUTE we melee, life betterw 132797524954796666