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HomeMy WebLinkAboutBrainerd Permit Application.pdfAll APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: dW,) a -;I_ Permit Number: SM L C E 4.. U 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: Ale v co, l(Q U PROPOSED IMPROVEMENT LOCATION: Arl. - I1 r-)f--, ..I f-f vest v-\ \i✓ b Property Tax ID #: 7 I — -7O ( — (7 pa (— OC-)C)— Lot No. Site Plan Name: Block No. Project Name: I DETAILED DESCRIPTION OF WORK: r 11 DS L New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additio I 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: $ 5 g( o U Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name C Vki I �Cf' \P Y J Name: i \ c-4N C5 Addr s: S ' U Company: V y[b�y . P— City: 0T,5��_(C_�(+\ ctJ^ State: Fl Zip Code: -: ' S --I Fax: -J Phone No. n�') -11 0 (ol 2 1 E- Address: 04 SE L City: -4fJC Y--f-State: Zip Code:-3L('? 4 Fax: Phone No-7'2d 02?7-(d-,)-% Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail OPi/N. 1 �+vrCILtC. GO Yt� State or County Lic9eCA-C V87W (49 If value of construction is 2500 or more, a RECORDED Notice or t;ommencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SU PLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESI NER/ENGINEER: Not Applicable Name. ORTGAGE COMPANY: _ Not Applicable ame: Addres : A dress: City: State: Zip: Phone Cit State: Zip: Pho e: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: UWNt:K/ LUNTKACfUR 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 commencine work or recnrdine vnur Nntirp of rnmmpnr•omant Wqrc tx Signature of Contra or - or - Owner guilder as applicable STATE OF FLORIDA COUNTY OF t5k--.Ls.&e. Sworn to (or affirmed) nd subscribed before me of Physical Presence or Online Notarization thlsZ& day of 201& by "1 1 M cr-I K\l We) I I!je-t S-7_ck Name of person maKing stateme t. Personally Known ✓ OR Produced Identification I� Typ entification Produced � a re of Notary Publ' - Sta tyFlorida) Commission No. (Seal) Notary Public State of Florida Jennie L Knight My sion tt HH 1815Commis54 Exp. 10/512025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED UAIt COMPLETED Certificate of Product Ratings AHRI Certified Reference Number: 8714905 Date: 02-25-2022 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TTR403OLl Indoor Unit Brand Name: TRANE Indoor Unit Model Number (Evaporator and/or Air Handler) : TMM4A0B30S2 I SA Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, NO, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 TRANE product Is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 2101240 - 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 : 29600 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 wnently 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. Ratinas that are accompanied by WAS indicate an involuntary r mte. The new Published reline is shown alono with the previous (i.e. WAS) retina. 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.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; Arim MEN entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's Individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be vented 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. ©2022AIr-Condltloning, Heating, and Refrigeration Institute CERTIFICATE NO,: 132e028e68604e2466