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HomeMy WebLinkAboutapplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - i - )- - Permit Number: 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 Residential Z� PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of tine PROPOSED IMPROVEMENT LOCAT N Address: C, S !s �- Legal Description: Q cf c- C_ i J— C_ `j 7--�-C_ Cc Property Tax ID #: 14 - J clQ - Lot No.�i Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: :ED.DESCRIPTION OF WORK: CON,STRVCTIO.N :INFORMATION: dditionaTw—orkt0banartormed under this permit -check all t= apply: �tVAC Gas Tank ❑Gas Piping _Q V1�indows/Doors aElectric a Plumbing [:]Sprinklers ElShutters Generator Roof Roof pitch Total Sq. Ft of construction: G c`y S . Ft. of First Floor: Cost of Construction: $ -2-- --/OD Utilities:0Sewer aseptic Building Height: OWNERAESSEE: CONTRACTOR: , Name s �r.�� �'�^ (c. r` .� Name: L c-, A z_rr "` `� ...-. Address: a c. City: S LG tate: %"C, Company` m C,,,, C' Address: C, -- Zip Cod -1 Fax: City: _ Z2 K C- State:_,�- Phone No. Zip Code 3,_1 3 Fax: E-Mail: Phone No. ---7 0 l -( f-3 Fill in fee simple Title Holder on next page (N different E-Mail: C u -n -- •-=' C3 �►-�.L State or County License: C_ % C i from the Owner listed above) If value of construction is SZs00 or more, a REcoRvcu nonce or a.vmmencemens 1s r�gaIrew. FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: iNot 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 is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit 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 undergoinga full concurrency 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing,': consult with lender or an attorney before commencing work nr rpcnrdina vnur Notice of Commencement. i a ure of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S `; t r" L COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _'�_ day of i=k-`i� , 20-� by this _ day of i-:i� , 20,4- -by -- Name of person rt)aking statement Name of person making statement Personally Known J OR Produced Identification Personalty Known Produced identification Type of Identification Type; of Identification Produced Produced TAYLOR GAGNE uY J1pAY P(�A/TA Y LO R G AG N E fir° G .Notary Public -State of Florida Notary Public -State of Florida .= -� Commission # GG 293167 = �. (Signat o, oF<, "'ry i ic-ft atgi (Signature P(b R�ubtic January 21, 2023 Commission o. """""""""""" Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 Certificate of Product Ratings AHRI Certified Reference Number: 203459936 Date: 02-07-2022 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: AMERICAN STANDARD Outdoor Unit Model Number (Condenser or Single Package) : 4A7A4018L1 Indoor Unit Brand Name: AMERICAN STANDARD Indoor Unit Model Number (Evaporator and/or Air Handler) : TMM4130A18S21 SAA 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 - 2017 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 : 18000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 12.20 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 confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; AM 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 "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. 132887096773305316 ©2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: