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HomeMy WebLinkAboutPermit ApplicationAll APPUCfiBLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Z 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: IMPROVEMENT Address: Property Tax ID#:) �AJW- ✓) W- U11,11 - Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Lot No. I I Block No.-91 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: �' ' Cost of Construction: $-I I q, Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name \ k Name: m icowe Addretss: 'L\i� C QC Company: S [ City: Ti xt f lCrC.� State: fL Zip Code: Fax: Phone No.1 o_�09 E- Address: c CitYPW , X� 1p-A U1lCA , Zip Code: J �� Fax'(�11fA3-�L+ Phone No-1 -12 ,8 ^ 3CZD State: Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail (4CO- C UO State or County LicenseC C it value of construction is Z500 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. f SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: 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 attorney before commencing work or recording your Notice of Commencement. Signatur of ontractor-or-OwnerBuilderasapplicable STATE OF FLORIDA COUNTY OF Sw n9�o (or aff'(�Qe and s bscr'bed before me of _ Physical Presence or Online Notarization 4 �i 11 thi day of ,�r 201 j by Name of person making statement. Personally Known ORPcoduc'ggd", Identification Tygp of Identification Produced U CeQr, 3� (Signature of Notary Public- State of Flon (e �/ Commission Noel Wn.� n)) oil ATHERINE MILLER e of Florida -Notary Public (Seal) mmission1f GG 273315 Expires 7w, yCommission November01, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/12/21 Certificate of Product Ratings AHRI Certified Reference Number: 7502926 Date: 11-24-2021 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: SILVER 14 Outdoor Unit Brand Name: AMERICAN STANDARD Outdoor Unit Model Number (Condenser or Single Package) : 4A7A4048L1 Indoor Unit Model Number (Evaporator and/or Air Handier): TEM4AOC48S41+TDR Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, 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 AMERICAN STANDARD product is responsible for the rating of this system Combination. Rated as follows in accordance with the latest edition of AHRI 210/240 with Addendum 1, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI'-sponsored, independent third party testing: Cooling Capacity (A2) - Single or High Stage (95F), bluh : 47500 SEER : 14.50 EER (A2) - Single or High Stage (95F) : 12.00 1"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. Ratings that are accompanied by WAS indicate an involuntary re-rate._The new published rating is shown along with the previous fie. 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 responsibility for, the products) 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.ahrtdirectory.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, AM personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information forthe model cited on this certificate can be verified at www.ahrldirectory.org, click on "Verify Certificate" link we 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 fight. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132822409712846234