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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICAB E INFJ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Z ! Permit Number: _ SQL Ll'�'CM V J r P Buildinr Planning and Development Services .� Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Commercial CBDG Funding 1r1ila iKr fd- Residential_ PROPOSED IMPROVEMENT LOCATION: 9 Address: . 1 i _ f\ 1 7 Property Tax ID #: lu ' - Lot No. L Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: 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:$ 7l 1z Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name i Name: Addr s: Compan f15if- ` City: i M J StateArl Zip Code: Fax: Phone No.��EDN 7.E- Address: �S City: YMIMEube, State: Zip Code: U Fax: PhoneN Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail K ft ^cc�Q aaj State or County License 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. PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attornev before commencing work or recording your Notice of Commencement. Signature ofC tr Por- or - OwnerBuilderasapplicable STATE OF Q� u-1 JJ COUNTY OFORIDA Swor to (or at med an sc ibed before me of _ Physical Presence or _ Online Notarization this day of 20_1J by Name of person making statement. " Personally Known OR Produced Identification T �,�f:�d�enntification Produced Q P U,V V(At AAf— (Sign�of Notary Public- State of Florida) 2'►�15(Seal) """ CATHERINE MILLER Commission No ��,, „ Public �''-;State of Florida -Notary 15 +; Commission # GG 2733 a; My Commission Exp es 2022 O„oM1,p November 01, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/1Z121 Eligible for Federal Tax Credit Certificate of Product Ratin AHRI Certified Reference Number: 9033755 Date: 11-30-2021 Model Status : Active AHRI Type : HRCU-A-CB (Split System: Heat Pump with Remote Outdoor Unit -Air -Source) Series: SILVER 15 Outdoor Unit Brand Name: AMERICAN STANDARD Outdoor Unit Model Number (Condenser or Single Package) : 4A6H5030H1 Indoor Unit Model Number (Evaporator and/or Air Handier): TEM6AOB24H21+TDR 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), btuh : 28600 SEER : 15.00 EER (A2) - Single or High Stage (95F) : 12.50 Heating Capacity (1­112) -Single or High Stage (47F) : 27800 HSPF (Region IV) : 9.50 f"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 am accompanied by WAS indicate an involuntary re -rote. The new Published ratina is shown alone with the Previous (i.e. WAS) ratirm. 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 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 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, Pin personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information forthe made] cited on this certificate can be verified at www.ahridirectory.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 right. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132827759555038450