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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: 5` 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: PROPOSED IMPROVEMENT LOCATION: Address J Property Tax ID #: �= ��y aD6 , Lot No. Site Plan Name: / /( P I raS �� S Block No. Project Name:( l ^ Q^ n ►� �� DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Add=ical rk to be performed under this permit -check all that apply: — Gas Tank —Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ S S OWNER/LESSEE: (Affidavit required) Generator — Windows/Doors _ Pond Sq. Ft. of First Floor: Utilities: _Sewer _ Septic City: t« / P / State:f Zip Code: 3q5dfR" Fax: Phone No. 772 -'i Ze 175 - E- Mail Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Roof Pitch Building Height: Name: ►V► i l.ka ej Company: et e0a �, S �c�ln7 (4 AC Address:-S City: State:. Zip Code: 31!f' '2 q Fax: Phone No g , l - 31 a' 32-z E-Mail 6-r i State or County License AC / 4 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 CONSTRUCTIO trEN LAW INFORMATION: DESfGNER/ENGfNEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Address: Name: City. Address: Zip:Phone State: City: State: Zip: Phone: ---- FIrC SIMPLE TITLE HOLDER: L-'Not Applicable BONDING COMPANY; Name: :'Not Applicable Address: Name: City: I Address: I Zip; Phone: Cit � ZipY• Phone: OWNER/ CONTRACTOR AFFIDVlT: 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, whichis inoconfllct with any representation that Owwners Assoplationru esabylaws or and covenants that build ay rthe estrict ojrC subject such structure. Please consult with your Home Owners 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN ANCING, CONSULT WITH YOUR LENDER OR -AN ATT Y BEFORE RECORDING YOUR NOTICE OF COhIMENME " Signature of Owner Less`re/Contractor as A ent fo caner I — Z `y v g I Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF /-)7 The forj Ing instwm nt was acknowledged before me this day of OC �D i�.aA 20:1!�% by N . Name of person making sta ment. Personally Known Produced Identification Type of Identification Produced _ ature of Notary Public- state of Comdnissio 0 .101 �; K: �: . SWEer (Sei _°/* � °so!ic - Stale of Florida Corrmisswn o GG 315466 REVIEW kTE CEIVED PLETED STATE OF FLORIDA COUNTY The forgoing instr�im n was acknowledg.F before me this day of (� j y� _J 204 by Name of person making stement. Personally Known V OR Produced Identification Type of Identification of Notary public- State of Florida J Commission i SUPERVISOR PLANS l REVIEW REVIEW K LLIF J. SWEET 'rotary 20k Statc of Florida IANGROVE REVIEW Certificate of Product Ratings AHRI Certified Reference Number: 7492906 Date : 12-17-2021 Model Status: Active AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled) Series: R41 OA AC SPP Outdoor Unit Brand Name: ARCOAIRE Outdoor Unit Model Number (Condenser or Single Package) : PAJ448000K**OA 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 ARCOAIRE 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 : 47000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 11.50 t"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 (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 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 1101 confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated;VIM ENM entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verity Certificate" link ,,,,,I<o lilr hcucr" 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. 132842359108071551 ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: