HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Applicati®n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Prone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential �
PERMIT APPLICATION FOR:'To
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Address: 9,i?
Legal Description:
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Property Tax ID #: _ 0d
Site Plan Name: 0
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Project Name: qr� Block No,
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right Side: Left ,Side:
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Total Sq. Ft of Construction:
Cost of Construction: i 00
aii apply;
Shutters
Generator
Sq. Ft. of First Floor-
Utilities:
loor: P_
Utilities:0Sewer Ose, tic
Name
Address: �� C4� ►� l
City: -YT `S -t- L-;..1(' k_k_
S#ate:,
Zip Code. i Fax:
Phone No. 1-4�-
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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Windows/Doors
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Building Height: ___
Name:C e t }
Company: A-0,Jj.
Address: Le 'a77 i L�-�'�
City:1,L,,t e State: L_
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Zip Coax: 77" — 1q5L-i -36 1
Phone No. -17�, S`71 - t O
E -Mail:
State or County License: & a
If Value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Name:
Address
City:
Zip:—
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: _ Phone:
_ Not Applica
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State.
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. 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 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, 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 Icor recordi jr Notice Of Commencement--- ----
_ Signature of Owner/ Lessee/Agent
Signature of Contractor/License H
STATE OF FLOIDA STATE OF FLORIDA
COUNTY( n VT COUNTY OF 4'T
The f�o,� oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l9 day ofd Zp 4by this day of 20 J_�o by
(Name of person acknowledging) (Name of person acknowledging )
d'i
of Notary Public- State of Florida )
Personally Known Y--' OR Produced identification
Type of- dentificat on Produced
Commission _No�
°�� LINDA PAARIC SOUCHARC
_•=` ;•- MY r.nrAMISSiON #FF125526
Revised' 0 ,' i5/
�4��98-0193
REVIEWS - FRONT
I COUNTER
I COMPLETE
I INITIALS
EXPIRES May 21, 2418
g ature of Notary Public- State of Florida )
Personally Known � OR Produced Identification
Type of Identification Produced
Commission
ZONING SUPERVISOR IPLANS
REVIEW I REVIEW REVIEW
JINDA-NIARIE BOUCFiARE
My COMMISSION #FF125526
EXPI RES May 21, 201 a
398-0153
VEGETATION I SEA TURTLE J MANGROVE
REVIEW REVIEW jj REVIEW
This combination qualifies for a Federal Energy
An't 1! ICERTIFIEDu Efficiency Tax Credit when placed in service
irectory. org between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certified Reference Number: 7599441 Date: 4/18/2016
Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source
Outdoor Unit Model Number: 4A6117036131
Indoor Unit Model Number: TE M6AOC36 H31 +TD R
Manufacturer: AMERICAN STANDARD
Trade/Brand name: AMERICAN STANDARD
Series name: PLATINUM XM
Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD
Rated as follows in accordance with AHRI Standard 2101240-2008 for Unitary Air-Conditioning and Air-Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 36000
EER Rating (Cooling): 12.50
SEER Rating (Cooling): 17.00
Heating Capacity(Btuh) @ 47 F: 32000
Region IV HSPF Rating (Heating): 9.60
Heating Capacity(Btuh) a, 17 F: 20800
" 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,
the produc(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 farm 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 he verified at www.ahridirectory.org, click on "Verify Certificate" fink N.� make life better-
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.: 131064603184610757