HomeMy WebLinkAboutBuilding Permit ApplicationALL 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 YJ
PERMIT APPLICATION FOR: To Select from drophox, click arrow at the end of line
Address: TJ. 93
Legal Description:
&ksk_�- -.i-Atp1)
Property Tax lD #: '0(1 - W —OC C:) _- Lot No.
Site Plan Name:
Project Name:
Block No,
ap.-)A { O 1C -Go it -ecz_:art' i 1P
rtLi lEIllyJf IAI WDf K LD De errormea under this permit c ec a app y;
i�VAC _Gas Tank []Gas Piping _ Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction: S. Ft. of First Floor: _
Cost of Construction: $ (OLi�`1 -- Utilities:'nSewer Septic
Name
Address: Iq?) � ���c�-�l�rn
City: YT S-17 L -Lt _A ' State:
zip Code:ay(. v Le Fax:
Phone No.
E -Mail:
Name:
10
Windows/Doors
Roof
Building Height:
Company:`
Address: LC. v1? 5 e} -
City: Q L -c1 State: E(_ _
Zip Code: '?AC495 Fax: -77' ), - C-4 5`-I
Phone No. -1-7A '7A 9-71 - IGLO 0
Fill in fee simple Title Bolder on next Page (if different E -Mail: "rev kC - IYI
from the Owner listed above) State or County License: 1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
RAI,a
W
DESIGNER/ENGINEER.
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
PLANS
Name:
SEA TURTLE
Address:
Address:
REVIEW
City:
State:
City: State:
Zip: Phone:
REVIEW
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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
commencing-afftrtc-or recordiLn eLIr Notice of Commencement,-----_
Signature of Owner/ Lessee/Agent
Signature
se
STATE OF FL DASTATE OF FLORIDA
COUNTY OF V0 J. C`. � COUNTY OF V0-tT � L-2tCA_Q__
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 0,jQn L_ 20 4by this _1L day of .Ag2y- I. I , 20 by
(Name of person acknowledging } (Name of person acknowledging j
M t V&
ignature of Notary Public- State of Florida) (VfAature of Notary Public- State of Florida j
Personally Known � OR Produced Identification
Type of identification Produced
Commission No ea
1 k
My(, #FF125526
F_xPIRES May 21, 2018
Revised 0"`;1_5/ n �ts99 Q193 FloridallotaryService.cnm
Personally Known � OR Produced Identification
Type of Identification Produced
Commissi
399-0153
MY COMMISSION #FF125526
May 21, 2019
REVIEWS -
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certified Reference Number: 7559635 Date: 4/18/2016
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: 4A6H7048A1
Indoor Unit Model Number: TEM6AOD48H41+TDR
Manufacturer: AMERICAN STANDARD
Trade/Brand name: AMERICAN STANDARD
Series name: GOLD 171 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):
47500
EER Rating (Cooling):
12.50
SEER Rating (Cooling):
17.00
Heating Capacity(Btuh) @ 47 F:
46500
Region IV HSPF Rating (Heating):
9.60
Heating Capacity(Btuh) @ 17 F:
30800
` 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 products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes
no responsibility for,
the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the producill 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 All 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;
A
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.
DITIONING, HEATING,
CERTIFICATE VERIFICATION
& REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
w make lime b&te)—
which is listed above, and the Certificate No., which is listed at bottom right.
--
02014 Air -Conditioning, Heating, and Refrigeration Institute
CERTII'ICATE NID.:
1 31 05460396962 791 7