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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:~Permit Number:_ 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 Md~:~I~Q~Dduili~~~e~_ Legal Description:diaL\-CJ..p %~N\trW 2 50\-(in?E ~11.()OIetl.1Xier A"J Q'1:.-3:b0wn ''''~L 81?1-2&ew0•g,Ilo5Fr FOepo13JTt!e ID'l'3 EbTIIS3'3C Ff"111<ls.J IlnlleT)Tt-1 ~'?i~1)rr/t)PD~lE5S w3to Pi £Or Rt:J f?J1i). Property Tax ID #:~40,3-.323 -ODD'~Dt::b-s....:Lot No._ Site Plan Name:_ Project Name:_ Setbacks Front._ Block No._ Back:Right Side:Left Side:-------------- ,0 \60)\4.55reQ.. o Windows/Doors DRoof Total Sq.Ft of Construction:_ Cost of Construction:$!:I1..::..00-=--2-_D _ S~of First Floor: Utilities:USewer DSeptic Building Height:_ Name e,Me Chtrth b.f ~. Address:6l~0 l.eand""""e"-.-r-.!AJ---'-!..>eJ)=-cu...,-e.-"'--_ City:fDr±--¥lerce State:~ Zip Code:34q~'d-Fax:_ Phone No.I/2-.sq 5 -ba3\.o E-Mail:_ Fill in fee simple Title Holder on next page (if different from the Owner listed above) DESIGNER ENGINEER: Name:~---------------------Address:~---- City:State:Zip:Phone:_ _Not ApplicableMORTGAGECOMPANY:Name:_ Address:---=:--:-_ City:-::-;-State: Zip:Phone:_ BONDING COMPANY:Name:_ Address:_ City:._ Zip:Phone:_ FEE SIMPLE TITLE HOLDER:_Not ApplicableName:_ Address:_ City:--=-:---_ Zip:Phone:_ _Not Applicable 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 thesermit holder to build the subject structurewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,bylaws or an 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 ~~tT~~Fci~ORI~{fd Lutt~ Signature of Contractor/License Holder ~~tT~~F ci~ORI~/n{[uc;e; The.forgoing instrument was acknowled~efore me this 2-S~ay of ',,,,la.rc~,20~by DllmL{el T .J)1I ;-hrl/)( The !9rg!ling instf\~ent was acknowledged before methis~day of I\i lQ.rck-,201110lbv G.rni/e!<tt rA (Name of person acknowledging) \\1111111/ (ignature of Nota7b'-Stateee ri!t~J *{~~....••••••y/')~~~.'\.'l-P1RES •••v~ Personally Known o~,#~~~~ntifici\j~ Type of Identification Producetu:~;::,~1.~'5~=~::;~•k ~.g:tJ.J::':-::.d:.~o ~~<;::)~..s.t-=::Commission No..;;',D""(tt'i"Il#"'~~~.-1"4 "<!~."'~~<;~'!~o·~..~~~~ Revised 07/15/2014 REVIEWS MANGROVE REVIEW DATE RECEIVED FRONT COUNTER ZONING REVIEW SUPERVISOR PLANS REVIEW REVIEW VEGETATION REVIEW SEATURTLE REVIEW DATE COMPLETED rIII. IIIIIIIIIIII I.IIII III ______d_uc_t_R_a_ti_n _5 11 IIIIIIIIIIIIIIIIIIIII AHRI Certified Reference Number:7517311 Date:3/25/2016 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:GSX140481K* Indoor Unit Model Number:ASPT48D14A* Manufacturer:GOODMAN MANUFACTURING CO.,LP. Trade/Brand name:GOODMAN;JANITROL;AMANA DISTINCTIONS;EVERREST;ONE HOUR AIR """••••••••••I •....,••••1 ••••••••,..,.••••••••••••I""t.••••~,~••••••••,••••••,"",II' Region:All (AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,10,IL,lA,IN,KS,KY,LA,MA,MD,ME, MI,MN,MO,MS,MT,NC,NO,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SO,TN,TX, VI,V 1"'\,V I,YYr'\.,".V,"',."',v.~.IGIII"UIIG~J Region Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be installed in all reqlons until June 30.2016.Be!:1innin!:1July 1.2016.central air conditioners ".u,VII'Y IJO:::"'>:>LCl"O:::U"',t:~'VII\::'/'V'""""••,LIIO:::YlI,o:::t:L Lilt:'t:!:J'VIIClI t:1I1.;,t:""y 1t:\.fUIIO:::"'O:::IIL. Series name:GSX14 Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO.,LP. Rated as follows in accordance with AHRI Standard 210/240-2008 for Unltarv Air-Conditionina and Air-Source Meal:r-ump e.quiprnenr ana sUDJeCll:O vermcauon OTraung accuracy DY AMI'I.I-SpOnsorea,moepenceru,truru party testing: r.nnlinn r.~n~r.itv(Rft ih):4Rnnn EER Rating (Cooling):11.70 14 &;n lEER Rating (Cooling): *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)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, ~~~~th~~~~d'~it~;~ti-;;~~fd~t-';ii~t~d-o~thiS C~;tifi-~te:'C~rtifi;d -r~ti~g~'~'re~aiid ~~~-f~;;;od~I~'';nd ~~~fig~r"atio~;list~d-in'"t-he-._.----'-,-'-----,-"-'_.- directory at www.ahriliirectory.org. TERMS AND CONDITIONS This Certificate and its contents are ornonetarv nroducts of AHRt.This Certificate shalf nnlv be used for individual.nersonal and couuceuuai rererence purposes.lilt comems 01 uus \..t:nlflt;a(t::Hli::lY nor,III wntne or 10 PCfHf ue reprvouceu;copreo;o.ssemmareo: 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 AIR-CONDITIONING,HEATING, &REFRIGERATION INSTITUTE 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 ~~~~~~~~~- ©201.4 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.:,