HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : 7i2 Permit Number:
44o LIUis
Q a o a Il ot� 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 : c� 3 aS �0. Y� CW i ✓�S� U
Property Tax ID #: ��13�e O ? l�c� l� - 00�� Lot No .
Site Plan Name: Block No.
Project Name :
DETAILED DESCRIPTION OF WORK :
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o t Sin 11aSe�►� LP0000 9TLK �Viwy�-9I OCIeo G� V 'l
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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 : $ (QQ 60 Utilities: — Sewer Septic Building Height:
OWNER/LESSEE : CONTRACTOR :
Name Dep w, '(&M , D ( S kA k yy 'W ( L C, Name : iN\,Q� 14 - I x;� e•-1Lc�
Address: 30 o S to ` 1 - Company: r &nCU4ibin
City: State: L Address: Mf o// CDrkI�L� A
Zip Code: 149 $� Fax: City: � :±y &0( 6 State: PLL
Phone No. E- Zip Code: 3 ZA Cc O Fa)C 5e Z 53 y�y
Mail : Phone No 1 S1eZ - Z� 3
Fill in fee simple Title Holder on next page (if different E-Mail Oe.Y ,IAA (00 k v G L' 4 4�a \ • Lo '�
from the Owner listed above) State or County License_ . D C 7 �X S' 1.
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 : City: State:
Zip: Phone Zip : Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ot 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 nonresidential use
WARNING TO OWNER: our failure to Record a Notice of Commencement may result in paying twice for
improvements t ir property. A No ice of Commencement must be recorded in the public records of St.
Lucie Coun y a p ted on th ob i before the first inspection . If you intend to obtain financing, consult
with I r o an a orn a re o encing work or recording our Notice of Commencement.
Sigrpfur6 of, ontractor - or - Owner Builder a licable
STATE OF FLORIDA COUNTY OF Tend i� PU
Sworn to (or affirmed) and subscribed before me of L Physical Presence or . Online Notarization
this 3 ( day of 202Zby
P\QJ� " k- t�
Name of person making statement.
Personally Known _ IVC OR Produced Identification
Type of I entification Produced
l
(Signat re of otary Public- State of Florida)
Commission No. " ( 1 (Seal)
$ wZ IENNIFERMADOLORESCRISANTE
MY COMMISSION # HH3174
�e EXPIRES: May 255 2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
Eligible for Federal Tax Credit
r.
1
Certificate of Product Ratings
AHRI Certified Reference Number : 10093803 Date : 01-27-2022 Model Status : Active
AHRI Type : RCU-A-CB (Split System: Air-Cooled Condensing Unit, Coil with Blower)
Series : XR16
Outdoor Unit Brand Name : TRANE
Outdoor Unit Model Number (Condenser or Single Package) : 4TTR6061C1
Indoor Unit Model Number (Evaporator and/or Air Handier) : TAM9A0C60V51
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, 20% 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 TRANE product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1 , Performance Rating of Unitary
Air-Conditioning & Air-Source Heal Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (9517), btuh : 57500
SEER : 16.00
EER (A2) - Single or High Stage (95F) : 13,00
L
tive" 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
keted but are not yet being produced"Production Slopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
ng or offering I ale.ings that are accompanied by WAS indicate an Involuntary re-rate. The new oublished reline is shown alone with the previous (i.e. WAS) ratinG.
CLAIMERI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
product(s) Ilstetl on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product($), or the
uthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations Ilstetl in the
ctory at www.ahridirectory.org.
MS AND CONDsconte Certificate and Its contents are proprietary products of AHRI. 7hIs Certificate shall only be used for individual, personal and
fidential reference purposes. The contents of this Certificate may not, In whole or In part, be reproduced; copied; disseminated;red Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's Individual,
onal and confidential reference. AIR-CONDITIONING, HEATING,
TIFICATE VERIFICATION & REFRIGERATION INSTITUTE
Information for the model cited on this certificate can be verified at www.ahridirectoryorg, click on "Verify Certificate" link we make life betterm
enter the AHRI Certified Reference Number and the date on which the certificate was issued,
ch Is Ilstetl above, and the Certificate No., which is Ilstetl at bottom right.022Air-Conditloning, Heating, and Refrigeration Institute CERTIFICATE No 132877635106694765