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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II /� t� Date: in, Permit Number: 1,V 2016. . Building Permit Application PERMITTING Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential `V PERMIT APPLICATION FOR: .aacL � �s-� ,aa- ..�v�:.s��.z��.w.�.� msxe):a�..� e.. c� '° e'.uki w Sid , aro,. °v u�l t to-;;, T s�c..�*•o Address: 6o�)- Pov 1 y mo,(r p KW y Legal Description: Property Tax ID#: (01 160 5 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DTAILEDDES;GRIPTI"ONOF UNORaK: e*-Woe ou liffmi 11$W111 0:1 Cohc��hSc r ph C.®'NSTRUCTI®N INF®R11/IATI®N: 10— Additional work to be pertormed uncler this permit c ec all that appy: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: �7 Sq. Ft. of First Floor: Cost of Construction:$ I �d�� Utilities: _Sewer _Septic Building Height: ®W�NER/LE SEE: CONI"RACTTOR: J Name P7/ Ae I &0/7r&,n Name: in U N Address: 6602 o lomar IDKwy Q Company: G�T�f CC)Ut?T_Y 1(ttv J17c City: 74tpf cl`C'-� State:_rL Address: /1tw �-bWX �xr Zip Code: Fax: City: s State: FL- Phone No. T7)-)- Zip Code: � '�( �6 Fax: 4 E-Mail: Phone No �7 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License CAC / 8-1 7`73. If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C®MOT"RU�1"I©N LIEN LAV1/ INiF®RMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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. jThe 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 wok or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/ icens Holder STATE OF FLORI STATE OF FLORID COUNTY OF • WC,t�_ COUNTY OF tA )C , , The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this M day of MY2\y20-Itpby this_ICI day of Ml 204 by (Name of pers n ackn wledging) (Name of pers n ackn ledging) (Signature of Not ry Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification / Personally Known OR Produced Identification Type of Idention Type of Identific tion Produced oduced —/. .L� \•aY KAREN S. NIELSEN r fission# FF 11563 Commission No. `J - - *€ �°e` R mmission No. (Seal) ommission Expires June 12, 2018 KAREN SF 1\1. NfELS�` 'q,a Po.? My Com on#FF 1 1 563 r REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO M'/UR 1 F3fRi ME COUNTER REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED lev. 7/2014 0 %,ertiflcate of Product Ratings AHRI Certified Reference Number: 7984193 Date: 5/10/2016 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX140301K* Indoor Unit Model Number: ARUF31 B14A* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN; JANITROL;AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR CONDITIONING AND HEATING; ENERGI AIR 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, Rl, 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. 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 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): 28200 EER Rating (Cooling): 11.50 SEER Rating (Cooling):. 14.00 IEER 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, 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.ahrldirectory.org. TERMS AND CONDITIONS . This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and AM 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.ahridIrectory.org,click on"Verify Certificate"link we 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. ©2014 Air-Conditioning, Heating,and Refrigeration Institute RTIFICATE NO.: 131073623233116940 µCE