HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential�DZ9�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 CBDG Funding
F21111 _U•\ 9
Address: L (L (� � �cu C Z 2* -2-
Property Tax ID #: J
Site Plan Name:
Project Name: s C.U+ � A° � e" -S " `�
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
K Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 6-ql) R . t_z�
(Affidavit required)
Generator
Lot No._ILi� t +�
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: -Sewer —Septic Building Height:
Name Lo k A i �+Pvv `7 � ',J..J-i
Address:: aZ Le, (tie tjiiK4s
City: � b r i- —'� �t��l 'e State: FL
Zip Code: G�—�� .0 Fax:
Phone No.ko al E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: l--i r�
S S
Company: r,ca ""'j it ,
Address: 358�( W GAJa.6 J�� '
City: A0r,,A.120w�!2 na2J2 State: 7�
Zip Code: ,3'T� Fax:
Phone No "1 D v
E-Mail CA :,.( CaA-
State or County License C/ACo,5(-R -) I
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.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip; Phone: _
_.__ Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
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 ures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNI G T OWNER: our failure to Record a Notice of Commencement may result in paying twice for
im rove ents toy ur property. A Notice of Commencement must be recorded in the public records of St.
L ie Co my d s ed on the jobsite before the first inspection. If you intend to obtain financing, consult
ith len er a t me e commencing work or recording our Notice of Commencement
SI of 16 eff Lessee/Contractor as Agent for Owner
ST EO4 OF O 1
1
Swor to (or affirm and su scribed before me of ((physical Presence or Online Notarization
this ay of �v✓ 20:gby
n
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Name of person making s atement.
DULCE MARTINEZ
+P�BIi
P sona ly Known � OR P duced I entification a '` A`` ° Commission # HH 119702
T pe of dentifi ation Produced * '
NT oe Expires May 10, 2025
9TFoFevo�� Bonded ThruBudget Notary services
(Signature of Notary Public- S to of Florida)
Commission No, (Seal)
REVIEWS
FRONT
ZONING .
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev 5/tu/Zl
AHRI Certified Reference Number: 9192584 Date : 03-26-2022 Model Status : Active
AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower)
Series: 14 SEER AC
Outdoor Unit Brand Name : CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : CA14NA024*0**A*
Indoor Unit Model Number (Evaporator and/or Air Handler) : FV4CNF002L
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, 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 CARRIER 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 : 23200
SEER: 16.00
EER (A2); Single or High Stage (95F) : 12.60?
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.
Ratingth s at are accompanied by WAS indicate an involuntar�r_e-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;
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 verified at www.ahrldirectory.arg, click on "Verify Certificate" link
and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which is listed alcove, and the Certificate No., which is listed at bottom right.
132928013739642209
02022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: