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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO// MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -5-- l Q `- ICP Parmit Niimhcr- Coutvlrx< 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 arrow at the end of line /LhQW_0,_0 PROPOSED IMPROVEMENT LOCATION: Address: Legal Description�� o -- Property Tax R Site Plan Name Project Name: Setbacks Front Back: 0 DETAILED DESCRIPTION OF WORK: Right Side: Left Side: ]0111 i worK to ne ertormed HVAC 0 Gas Tank 11 Electric 0 Plumbing under this permit -check ❑Gas PipingShutters Sprinklers a appy: 0 Windows/Doors Roof OGenerator Total Sq. Ft of Construction: zz� Cost of Construction: $ t4 1Q,5 - SFt. of First Floor: _ Utilities:Sewer Septic Building Height: OWNER/LESSEE: s CONTRACTOR: Name Address: cR City: --Zebi, &zD State: _ �s Zip Code: -1 Fax: Phone No. -71 Name: Com an VI_ p Y� Address: 36S t -t �J 11S Cit - Y� '� '.a7k Q3,\e Q Zip Code: 0-, "A o Phone No. -)--)o- l\ E -Mail: L "'z),( Fax: u� �j I Stater �7`� 4iQa� g7c9,z:) E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: a� -��� �����•� w yr rrrure, d rccwrcvw rvotice or commencement is required. SUPPLEMENTAL CONSTRUCT N LIEN LAW INFORMATION: DESIGNER/ENGINEER: of Applicable Name: MORTGAGE COMPANY: of Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: of Applicable Name: BONDING COMPANY: N t Applicable 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 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 commencine work or recording your Notice of Commencement. ignature of Owner/ Lessee/Agent STATE OF FLORID`�� COUNTY OF The forgoing instrument was acknowledgedbefore me this, day of 00,2-4 , 20 / by (Name of person acknowledging ) Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced ature of Contractor/License STATE OF FLORIDA / COUNTY OF The forgoing instrument was acknowledged before me this /0 day of fill?_110/ 20 r 6 by (Name of person acknowledging ) (Si ature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No.Commission FRONT No. RA HOHMANN •Fav �, �, SAN RA HOHMANN ; Notary Public - State of Florida ;rk, ;`":', No Public - State of Florida .�� REVIEW :• . _ ��+ J°' My omm. xpu,,s .. ar , Commission # FF 071680 _ ,... Commission # FF 071680 Revised 07/15/201 ,�iF�UP•`` Bonded Through National Notary Assn Bonded Through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS AHRI Certified Reference Number: 7631480 Date: 5/10/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: CA14NA036****A Indoor Unit Model Number: FX4DN(B,F)037L Manufacturer: CARRIER AIR CONDITIONING Trade/Brand name: CARRIER AIR CONDITIONING 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, RI, 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: 14 SEER PURON AC Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING 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): 34400 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 15.00 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.ahrid'€rectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and in 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 & REMQERAT€ON INSTITUTE The information for the model cited on this certificate can be verified at www.ahrid irectory.org, click on "Verify Certificate" link we retake 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 CERTIFICATE NO.: 131073560519602816