HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _�� _ Permit Number:
' �J _ '
•
- - Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR:
ROPOSED IMPROVEMENT LOCATION:
Address: 8'00 s e v�k , LucyL
Legal Description:
Property Tax ID #: 3 ` d5- 06 - ()on -COO)
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
D� ETAILED DESCRIPTION OF WOR
CONSTRUCTION INFORMATION:
`Await oo�- n or to a per orme un er t is permit — c ec
Mechanical _ Gas Tank _ Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ —0 L103?9
apply:
Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic Building Height:
Residential
Lot No._
Block No.
Name
Addre 8� S '
City: v c� State: FL
Zip Code:3yi5'.)— Fax:
Phone No. ao y6 " 00 �F7
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof Pitch
Name: 'r
Company: 14 -r
Addr17y9t,
u City:Mate:
Zip Code: 3Y?V _ Fax: N'f
Phone No 71) -a-)V-9 8's
E-Mail
State or County License cel/ci y o
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone: _.—
MORTGAGE COMPANY
Name: --
Address:
City:
Zip: Phone.
i
Not Applicable
_,____._State:
BONDING COMPANY: Not Applicable
Name:
Address:
city
.-
-rip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do time worts and it staliation 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 su=,-re
which is in conflict with any applicable Nome Owners Association rules, bylaws or and covenants that may restrict or prof Tit sud
d;
structure. Please consult with your Home Owners Association and review your deed for arty restrictions wenmay apply -
In consideration of the granting of this requested permit, I do hereby agree that t will, in all respects, perform die 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 concunency review room additions,
accessory structures, swimming pools, fences, wails, 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 of Owner/ Lessee/Contractor as Agent for Owner Signature of Contrador/Ei tffm Haider
STATE OF FLORIDA
COUNTY OF
Swor Ao (or affirmed) and subscribed before me of
Physical Prese c r Online N nzation
this day of— 20_J by
Name of per n makin1g st/atement.
Personally Known V 4R Produced Identification
Type of Identification
Pr d
_M_�
(Signature of Notary Public- State of Florida)
Commission No. n (seal)
REVIEWS
DATE
STATE OF FLORIDA 9 / f�
COUNTY OF lJ
Swor to (or affirmed) and subscribed before me of
hysicaf Prom Online motion
this J�da,Xof 20Z, by
Name of persoWmahi mg/fit
Personally Known ✓ OR Produced klentirication
Type of Identification
(Signature of Notary Public S
ws;
SHELLCommission No. .... MYC.,.
REVIEW VERMEW l5VUEW E MANIEWVE
Certificate of Product Ratings
AHRI Certified Reference Number; 202717849 Date: 11-15-2021 Model Status: Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Outdoor Unit Brand Name: BRYANT HEATING AND COOLING SYSTEMS
Outdoor Unit Model Number (Condenser or Single Package) . PA4ZNBO36'
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, Hl, ID, R, 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 rCq*ns
until June 30, 2016. Beginning July 1, 2016 central air condrhoners can only be installed in regpon(s) for
which they meet the regional efficiency requirement.
The manufacturer of this BRYANT HEATING AND COOLING SYSTEMS product is responsible for the rating of Ibis system comhnatrort
Rated as follows in accordance with the latest edition of AHRI 2101240 with Addendum 1, Performance Rating of Unitary Air-Condllgnmp
& Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party tesnnq,
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 35000
SEER: 14.00
EER (A2) - Single or High Stage (95F) . 11.50
t"Active" Modol Status nro those lhal an AHRI Certification Program Participant Is currently fwxlunng ANin smiin.l or attisnng for sme: on I"* m xfoh that dill t-'0j1V
mnrkntai but ern not yet bon xl prorlucrM "Productron Stnppnd' frMdol Slatus am thoso that nn AHRI Ca+ din'ah, ii r`,iNisirn PArticipant is Ix1 bnl7eu pn cA ci,t,7 Nt1T s xt,
Soiling or offering for sale
DISCLAIMER
AIIRI dove not endorse the product(%) Iltiled on this Cettincnte and makes no reprsaentnitoim wanonlipe nr guroneteee ne to, and asutmea n,% iv i ,%ovtvtity hv,
the product(s) listed on this Cenificate. AHRI eKptetlely disclnlms nil Ilnbltity ter dmmngos of mry kind nustnK nut of the use of pe,Mnmorxvi of the (nittu: hxn, at the
unnathod:ed alteration of data listed on this Certificate. Corllned rntlnl(s are valid only tot models end connitrtirntions listen in the
d fr"oty at www.ohHdlreclery.org.
TERMS AND CONDITIONS "IMF
nits Certlflcale and its contents nproprietary pr,xldcte of AHRI. nits Certlacnte shell only he usrnl Mr Individual,I)erel+nnl ens
onnndenllet reference purpoess. The contents of this Certiacnte may not, In whole or In pnrt, be ropm duced; copied; dhi,%oo+lnatr l
entered Into a compuler database; or otherwise ulBlred. In any fotei of Inannet or by any means, etoept kq trip ustwa IndhHiunl. �■ -�
pemonal and confidential reference, AIR CVW0nW# IMQ, He Atl#riiii,
CERTIFICATE VERIFICATION Art REF MM1 " M fM0111ttft%
the intormeuon for the model tiled cn thls cerllficale cen he vertned et www.aertAlreefory.orrit, ON* on -Verify Certificate' link w�• ,++�kr : h• irt„ -`
"rid enter the AHRI Cartilled Reference Number and the date on which the evilficate was Issued,
which Is listed above, and the certlficnte No., which la listed at bottom Atoll.
02021 Air -Conditioning, Honttng, and Refrigorat(on Institute CERTIFICATE NO.: td'W1+N+r'.L4+ :.v-