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HomeMy WebLinkAboutCCF_000130.pdfAll APPLICABLE INFO MUSST7 BE COMPLETED FC Date: _ 1'/"1 /1 L1 -1� Luc-LL Bu Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 R APPLICATION TO BE ACCEPTED Permit Number: _ ilding Permit Application Commercial CBDG Funding Residential -C-'_ PERMIT APPLICATION FOR: � 0S ! PRnl?n5ED IMPROVEMENT LOCATION: Address: 1 1 Property Tax ID #: 14 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: _'T New Electrical Meter Second Electrical Meter LCqNSTRUCTION INFORMATION: Additional work to be performed under this mechanical _ Gas Tank _ Electric Plumbing _ Total Sq. Ft of Construction: 60 Cost of Construction: $�� nit — check all that apply (Affidavit required) Lot No. Block No. Piping _ Shutters _ Windows/Doors _ Pond nklers Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Building Height: Name Address: pe io _ City: State: j� Zip Code: 4 _ /Fax: Phone No. U A — Mail: Fill in fee simple Title Holder on next page (f different from the Owner listed above) Name: N ll Cxl[ Yy U --" — Company: �SI Address: _UJ City: \q c0 C 1 ` State.'L E- Zip Code: Fax: �2 '299 Phone No E-Mail&_f\J cc,S� l� C11 State or County License —CAL If value of construction is 2500 or more, a RECODED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDEP Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable Name: _ Address: City: Zip: Phon State FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: _ MORTGAGE COMPANY: Name: Address: Citv: Zip: Phone: BONDING COMPANY Name: Address: Ciry Zip: Phone: Not Applicable State: _Not Applicable OWNER/ CONTRACTOR AFFIDVIT: Applicatibn 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, walks, 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 attorney before commencing work or recording our Notice of Commencement. Signature of Contractor - or - Owner Builder as applicable STATE OF FLORID y COUNTY OF I it I dh V- Uf 1 Sworn to (or affir ed) and subscribed before me of Physical Presence or Online Notarization this A5L_ day of 2012 by Name of person making statement. Personally Known �_ OR Produced I Type of Identification Produced (Signature of Notary Publi- State df Florida) Commission No. 441411 WP�c� (Seal) REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Brilhey Fttir ftw Notary Public State of Florida Commli HH116860 Expires 4/13/2025 SUPERVISANGROVE REVIEWOR I REVIEW PLANS I VEGETATION EVI WI SEATURTEV EWLE M REVIEW- Eligible for Federal Tax Credit Certificate of AHRI Certified Reference Number: 7567544 AHRI Type: RCU-A-CB (Split System: Air -Cooled Series : XR14 Outdoor Unit Brand Name: TRANE Outdoor Unit Model Number (Condenser or Single Indoor Unit Model Number (Evaporator and/or Air Region : All (AK, AL, AR, AZ, CA, CO, C MT, NC, ND, NE, NH, NJ, NM, Territories) � 11,111110 , Ill - =0 Date : 03-15-2022 Model Status : Active ing Unit, Coil with Blower) 4TTR4031L1 TEM6AOC36H31+TDR , DC, DE, FL, GA, HI, ID. IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, V, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S. Region Note: Central air conditioners manufa tured 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 regions) for which they meet the regional ef 1ciency 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 Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 29400 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 1 t"Active" Model Status are those that an AHRI Certification Prpgram Participant is currently producing AND selling or offering for sale, OR new models that are being marketed but are not yet being produced. "Prod uction Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. - _ , , ;� ,1 n­ Ath rhP nmvious li.e. WAS) ratino. DISCLAIMER AHRI does not endorse the product(s) listed on this Certifical the product(s) listed on this Certificate. AHRI expressly disclz unauthorized alteration of data listed on this Certificate. Car directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of 1 confidential reference purposes. The contents of this Certific entered into a computer database; or otherwise utilized, in 2 personal and confidential reference. CERTIFICATE VERIFICATION The Information for the model cited on this certificate can b and enter the AHRI Certified Reference Number and the dat which Is listed above, and the Certificate No., which is listed ©2022Air-Conditioning, Heating, and Refrigl and makes no representations, warranties or guarantees as to, and assumes no responsibility for, is all liability for damages of any kind arising out of the use or performance of the product(s), or the ed ratings are valid only for models and configurations listed in the This Certificate shall only be used for individual, personal and to may not, in whole or in part. be reproduced: copied: disseminated; to y form or manner or by any means, except for the user's individual. �� AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better"' on which the certificate was Issued, __ ,t bottom right. ration Institute CERTIFICATE NO.: 1132918405394783443