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HomeMy WebLinkAboutCCF_000124.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � ZZ Permit Number: LL?ctE- �40�11"n� Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential QP 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR Address: 11�jU Property Tax ID #: Site Plan Name: Project Name: _ New Electrical Meter Second Eledtrical Meter C (Affidavit required) Lot No._ Block No. Additional work to be performed under this permit— check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ 3prinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 2 _ 00 Utilities: _ Sewer _ Septic Building Height: _ Name Name: Uunl - - S� Address: S i Company: wm City: fn' -e( C J; State: L Address: --10001CA I X Zip Code: 4 g151 Fax: City: v e (o State: EJ Phone No. — lLoA- E- Zip Code: \32q(.0 2 Fax: ��2- 2gC\ Mail: Phone No - q c� - q Fill in fee simple Title Holder on next page (if different E-Mail ((10W k CJ from the Owner listed above) State or County License (�.1�C 1�1 i_5c) 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 otice of Commencement is required. DESIGNER/ENGINEER: _Not pplicable Name: _ Address: City: Zip: Phon FEE SIMPLE TITLE HOLDER: _ Not Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: icable I BONDING COMPANY: Name: Address: City: Zip: Phone: — Not Applicable State: Not Applicable OWNER/ CONTRACTOR AFFIDVIT: Applica ion 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 g anting 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 ermit, 1 do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Floriclz 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, wal s, 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 jobsit before the first inspection. If you intend to obtain financing, consult with lender or an attornev hPforp rnmmanr^ina %Atnrl, nr o�,,.a; , . , ,._ ;__ _r _- - _ _ v1 Commencement plicable Signature of Contractor - or - Owner Builder as a STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of _Physical Presence or Online Notarization this L day of _ (C. . 20 1Zby 000 Name of person making statement. kigs Personally Known T OR Produced Identific tion Type of Identification Produced (Signature of Notary PubliU State oT Florida) i Commission No.h Seal) Br>kterry Froddlcaon Notary Public State of Florida • COMM# HH116860 Expires 4/13/2M5 REVIEWS FRONT ZONING S PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED_ DATE COMPLETED eev 10 — 1 •..►/ CERTIFIED www.ahridirectory.org "�roduct Ratinas AHRI Certified Reference Number: 7482041 Date : 03-03-2022 Model Status : Active AHRI Type: RCU-A-CB (Split System: Air -Cooled C ndensing Unit, Coil with Blower) Series: XR14 Outdoor Unit Brand Name : TRANE Outdoor Unit Model Number (Condenser or Single P ckage) : 4TTR40361_1 Indoor Unit Model Number (Evaporator and/or Air Haidler) : GAM5BOB36M31 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, O, MT, ND, 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 TRANI= product is responsi a for the rating of this system combination. Rated as follows in accordance with the latest edition f AHRI 210/240 - 2017 with Addendum 1, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment nd subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage 95F), btuh : 34600 SEER : 15.50 EER (A2) - Single or High ttage (951`) :'13. 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. Ratin s that are accom anied bv WAS indicate an involuntary re -rate. The new Published ratino is shown alona with the Drevious i.e. WAS rating. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate ind makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclainis 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. Certifi d 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 AH11 H. This Certificate shall only be used for Individual, personal and confidential reference purposes. The contents of this Certificat 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, personal and confidential reference. AM AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date oi which the certificate was issued, ne roa4e l iia ,er ri which is listed above, and the Certificate No., which is listed at 3ottom right. - - — - ©2022Air-Conditioning, Heating, and Refriger tion Institute CERTIFICATE NO.: 132908093490187448'