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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: !fin 1 C( l)-"I 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: ��h..Q �� PROPOSED IMPROVEMENT LOCATION: Address:(©o f1) IQ (l� L], Property Tax ID #: — (QDG7 - 00�) i — 00U - Gn Lot No. Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: f�7 New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical _ Electric _Gas Tank _Plumbing Total Sq. Ft of Construction: _Gas Piping _Sprinklers Block No. _Shutters _Windows/Doors _Pond Generator Roof Pitch Sq. Ft. of First Floor: Cost of Construction: $ �/ OCR Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name tE%eaC%,Ui Ck Name: 11�arIL �0�0. Address: 3(oa N A(A PH 130( Company:R',,rlr City: F 1 pi'cecR Stater Zip Code:. 05gC149 Fax: Phone No. E- Address: 1C 3(o 0®yh11n1,CP c b9v City: UQry Zip Code: N3 Q io CDi Phone Nop� �� a - Stater Fax: Sz L - 2.,L03 Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail i A reN b2jdL A-C�_Qftj tj •((344 State or County License Coe, & 7 2Sa, 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 CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: e Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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. int Lucie County and sted the jobsite before the first inspection. If you end to obtain financing, consult with lender or a ttor before mmencin work or recordin our Notice of Commencement. Si a f w r ess /Contractor as Agent for Owner STATE OF FLORIDA n `� COUNTY OF l C t✓4 f� Sworn to (or affirmed) and subscribed before me of Physical Presence or _ Online Notarization this a4L day of 8C.A 20a.1 by /vim V— uy\CkAek le z j� Name of person making statement. Personally Known X. OR Produced Identification Type of Identification Produced (Sign fire o ub - tat f Florida) Comm on No. I��� ( 1`/ (Seal) �JEMGERGMAIXNGPESCRISANfE MY COMMISSION 0 HH3174 ,ha EXPIRES: May 25, 2024 REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21 ti.wal CERTIFIED° www.ahridirectory.org AHRI Certified Reference Number: 205767481 Date : 10-29-2ort Model Status: Active Old AHRI Reference Number : Product : Water -to -Air and Brine -to -Air Model Number: TCV041A Brand Name : ClimateMaster Rated as follows in accordance with the latest edition of ANSIIAHRI/ASHRAE/ISO 13256-1 Water -source heat pumps --Testing and rating for performance -- Part 1: Water -to -air and Brine -to -air heat pumps and subject to rating accuracy by AHRlsponsored, Independent, third party testing: Full Load PartLoad1 PartLoad2 PartLoad3 Air Flow Rate - Cooling: 1015 Air Flow Rate - Heating: WLHP (Water -Loop Heat Pumps) Cooling Capacity (Btuh) 36500/36500 Cooling EER Rating (Btuh/watt) 13,20/13.20 Cooling Fluid Flow Rate (gpm) 10.00 Heating Capacity (Bluh) 45700/45700 Healing Cop (watt/watt) 4.30/4,30 Heating Fluid Flow Rate (gpm) 10,00 GWHP (Ground Water -Heat Pumps) Cooling Capacity (Sluh) 41400/41400 Cooling EER Rating (Btuh/Watt) 19.70/19,70 Cooling Fluid Flow Rate (gpm) 10.00 Heating Capacity (Btuh) 38000/38000 Heating COP (watt/watt) 3,70/3.70 Heating Fluid Flow Rate (gpm) 10.00 GLHP (Ground -Loop Heat Pumps) Cooling Capacity (Btuh) 38000138000 Cooling EER Rating (Btuh/Watt) 14,80/14.80 Cooling Fluid Flow Rate (gpm) 10,00 Heating Capacity (Btuh) 30000130000 Healing COP (watt/watt) 3.20/3,20 Heating Fluid Flow Rate (gpm) 10.00 Indoor Blower Motor Fan Type : PSC Sold In? : USA, Canada Where ra8ng shows valueNalue, the first value is at minimum voltage, the second value is a1230v Tor a dual volt system. t"Active" Model Status are those that an AHRI Cedi8ca8on Program Padicipant is currently producing AND selling or ofiedng for sale; OR new models that are being marketetl but are not yet being producetl'Produdion Slopped' Model Status are those that an AHRI Certificelion Program Padidpant is no longer producing BUT is still selling or offering for sale. Ratings that are accemoan. ed by WAS indicate an involuntary re rate The new published rating is shown along with the previous (i.e. WAS) rating DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responslbillty 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 JR King 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; A..■ `' 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,EFRIEATIINSTITUTE CERTIFICATE VERIFICATION 8 REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on °Verify Certificate' link „e make life 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. 132799902940885497 ©2ZEI Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO":