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HomeMy WebLinkAboutScan_Doc0036ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:~Permit Number:_ 5>~~~}l~, COUNTY . FLORIDA -- 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 ~ PERMIT APPLICATION FOR:To Select from dropbox,click here and UndiV G hare ~ Property Tax ID#:3535·1D'L·OD37·ODD"5 Site Plan Name:_ Project Name:_ Setbacks Front,_ Lot No._ Block No._ Back:Right Side:Left Side:_ Total Sq.Ft of Construction:_ Cost of Construction:$3lobl)QQ Shutters-IDGenerator-I S'}l!;of First Floor: Utilities:USewer DSeptic o Windows/Doors DRoof Building Height:_ Name y-0 e ,1--A.Cb '\ Address:C\~OO S,OeetU\.~it-5D\o -0 City:3en~()beMh State:~L Zip Code:340.57 Fax:_ Phone No.£>SO -601 -COI 2.S E-Mail:_ Fill in fee simple Title Holder on next page (if different from the Owner listed above) If value of construction is $2500 or more,a RECORDED Notice of Commencem DESIGNER ENGINEER: Name:~----------------------Address:--:-_ City:State:Zip:Phone:_ MORTGAGE COMPANY: Name:Addres-s:---------------- City:-:::-;-State: Zip:Phone:_ _Not ApplicableFEESIMPLETITLEHOLDER:_Not ApplicableName:_ Address:_ City:--:-:--_ Zip:Phone:_ BONDING COMPANY:Name:_ Address:_ City:_ Zip:Phone:_ OWNERI 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..LucieCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structurewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,bylaws or and covenants that may restrict or prohibit suchstructure.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 BuildingCodes and St.LucieCounty 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 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 commencin work or recordin our Notice of Commencement. I ature of Owner/Agent/Lessee STATE OF FLORIIiA (1 J /J ~/1;-) COUNTY OF ~~{JG(Luue/ Sig ature of Contractor/License Holder ~~'rr~~FC:~ORI~/n1 Luc;e; The ~instrument was acknowled~efore me this y of N.a.rck.,20Jllaj by Dttfnll£1 I.~II}-hll/lf The for!1q.inginstrument was acknowledged before me th~~aYOf\\A.a.(e-k-.2011"Iby Uamvel .tll/A (Name of person acknowledging)"-(Name of person acknowledging) Commission No.-----'~--=4ro::-Commission No.~_ Revised 07115/2014 REVIEWS MANGROVE REVIEW DATE RECEIVED FRONT COUNTER ZONING REVIEW SUPERVISOR PLANS REVIEW REVIEW VEGETATION REVIEW SEA TURTlE REVIEW DATE COMPLETED III,1'.1,I IIIIIIIIIIiIII,II IIIIIIIIII •...1IIIIIIillIIIIIIIII AHRI Certified Reference Number:7932228 Date:3/25/2016 II _5_,__~._;F ~II IIIIIIIIIII'It.....IIIIII IIIIIIIIIIIIII and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is fisted above,and the Certificate No.,which is listed at bottom right !----~--~~. ©2014 Air-Conditioning,Heating,and Refrigeration Institute !CERTIFICATE NO.:13103403453420407011 7i& Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:4TTR4030L 1 Manufacturer:TRANE Indoor Unit Model Number:TMM5AOB30M21SAA Manufacturer:TRANE Trade/Brand name:TRANE Region:Southeast and North (AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,TX,VA I'"\I'\.,,",U,'"'I,ILoI,II •.•,,,....,,II~,1'\.";','W'",••11;,.,11'11,'."',••IV,'.11,''''''',I"~,.-.f I,''''''', NY,OH,OR,PA,RI,SO,UT,VT,WA,WV,WI,WY,U.S.Territories) Region Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be 1I';:>Lc:lllt::U III c:lll '~~IOII;:'UIILII .JUII~~v,,c,v IQ.Dt::Y'"I1I1IY.JUIY 1,.o;.V IU,\i~IIL'c:l'c:lll \iUIIUllIUItt::,;:> can only be installed in region(s)for which they meet the regional efficiency requirement. Series name:XR14 Manufacturer responsible for the rating of this system combination is TRANE rcareu as TallOWSIn accoraance wltn AMI"(I etanoaru ",'IU''''''U-'''UUO Tor unitary Asr-c-oncmorung ana Arr-eource Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity (Btuh):29000 SEER Rating (Cooling):15.00 ._-_.••-~"'o::J ,---····>::11· *Ratings followed by an asterisk (*)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)fisted on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, ~~~~th~;;~~'d'~it~;~ti-;;~;;fd~ta J;~;d-o~thi~C~rtifi';;te~'C~rtifi~-d -r~ti~g~'~'r~~alid ~~iY-f;;;~od~l;:;nd';;~fig~~~tio;';I~t~ci;;the- directory at www,aluinirectory.org. TERMS AND CONDITIONS This Certifir.ate and its contents are nrnorietarv nrnducts of AHRI.This C"rtifir.nt"sh"n onlv he used for individual.nersonal and couuuenuen rererence purposes.I lie coruerus or lIlIS \"t::fUflt;(:Ht:IndY run,III WllfJlt or If!pan,ue reprouuceu;Cup leu;uesserumareu; 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. CERTIFICATE VERIFICATION Alfl-CCNDlTIONlNG,HEATiNG, &REFflIGERATION INSTITUTE IliIllEa.•••••••••••