Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutPermit ApplicationALL APPLICA LE INF MUST BE COMPLETED FOR APPLICATIO
Date:
Building Permi
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Ave nue, Fort Pierce FL 34982
Phone: (772)4E2-1553 Fax: (772) 462-1578
I TO BE ACCEPTED
Permit Number:
Application
CommeCal
Residential lz
PERMIT APPLICATION FOR: To Select fro*dropb, rrow pit the end of line
PROPOSED II�lPRO!/EMENT LOCI'�TlONAddress: % � e�+ [7 �� _ -3y 5 -D,
Legal Description J 1-0.5`i� 1� �x�c1 tJ 33 F7. LDf.
Property Tax'ID 4:
Site Plan Name:
Project Name:,,,
Setbacks Front
-I n I - 1) J 1'1A "?)/'; --
Back: Right Side:
3-70
Lot No. 14
Block No. --2-0
Left Side:
Ar Ncrt cezr) '5t&rnda,r-d w M -u
Add—itiV661 work :o bjeerformed under this permit— checK al apply:
_ HVAC Gas Tank []Gas Piping In Shutters
❑ Flectric ❑ Plumbing ❑ Sprinklers F]Generator
Total Sq. Ft of Co istruction: _ S Ft. of First Floor
Cost of Construction: o0o • <7 • Utilities: Sewer ❑ S:-ptic
Name
City A X ✓ 4— State:
Zip Code:'wya- _ Fax:
Phone No. 1i "— %+�g— I ss'
E -Mai!:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
❑ Windows/Doors
❑ Roof
Building Height:
me: ACL A 121a t,A LK "—Y X
mpany:91.0 4-.
dress: 50 A)f b /x► -e 1" (1 b -1
Y: s�-u� r t _ State: 79-1
Code:.{
one No. ZZ_- W 1olb& 5
�lail:Qrr�p Cc ( r' L,
ite or County U.-ense: 'A( %cj 317
If value of constru :tion is $2500 or more, a RECORDED Notice of Co jmencement is re )uired.
SUPPLEMENIAL CONSTRUCTION LIEN LAW INFO; MATION:
DESIGNER/ENC (NEER:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable A IORTGAGE COMPANY: _ Not Applicable
ame:
ddress:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: _ Phone:
p: Phone:
DNDING C PANY:
ame:
ty: N
p: Phone:
I certify that no work or installation has commenced prior to the issnce of a permit.
State:
Not Applicable
St. Lucie County m 3kes no representation that is granting a permit w I authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rul s, bylaws or and covenants that may restrict or prohibit such
structure. Please c )nsult with your Home Owners Association and re iew 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 wits- the approved plans, the Florida Building Codes ar I St. Lucie County Amendments.
The following built ing permit applications aru exempt from undergo g a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen ro( ms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of CI mmencement may result in your paying twice for
improvements -:o your property. A Notice of Commence ent must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financii g, consult with lender or an attorney before
commencing w )rk or recording our Notice of Comment ment.
F j,
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF_%I_J- jt -6A' LQQ
Sidnature
The forgoing instr iment was ack owledged refore me
thi -.: day of 20 LLilby t
0- Irrtri1
(Name of person a-knowledging)
C
(Signature of Notary Public- Aate of Florida )
Personally Known �OR Pror►liced Identification
Type of Identification Produced -i
Commission N
Revised 07/15/2014
CHRISTINE A 1r.W
•�Se1�114 COMMIS .ION q F 2a
+:_•...,ea� EXPIRES Jury 31. U1
TE OF NTY OF OR
J_=W&C- i, .l CZ
forgoing instruent was acknowledged before me
day of _/T Lam, 20 L& by
me df person acknowledging)
of Notary F'ul�ic- State of Florida )
ally Known ✓ OR Produced Identification
F Identification Produced_
sion No. F �J-sj CHI{ SMINE A JORDAN
_ MY COMMISSION # FF235578
6wr
REVIEWS
FRONT
ZONING
SUPERVISOR
PANS
VEGETATION
SEA TURTLE
MANGROVE
'OUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
1
11
Certificate of Product Ratings
AHRI Certifd Reference Number: 7985234 Date: 7/27/2019
Product: Spl System: Air -Cooled Condensing Unit, Co'► with Blower
Outdoor Uni Model Number: 4A7A4036L1
Manufacturlodel
: AMERICAN STANDARD
Indoor Unit Number: TMM5AOB36M31SAA
Manufacture
AMERICAN STANDAKD
Trade/Brand AMERICAN STANDARD
Region: Sou east and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, IVIS, NC, OK, SC, TN, TX, VA
AK, CO, CT, , IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ,
NY, OH, OR, A, 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 a I regions until June 30, 2016. Beginning July 1, 2016, central air conditioners
can only be 1 stalled in region(s) for which they meet the regional efficiency requirement.
Series name: SILVER 14
Manufacturer responsible for the rating of this system c
Rated as follows in accordance with AHRI Standard 2101
Heat Pump Equipment and subject to verification of ratil
party testing i
Codling Capacity (Btuh):
EE Rating (Cooling):
SE R Rating (Cooling):
IE Rating (Cooling):
35000
12.50
15.00
mbination is AMERICAN STANDARD
0-2008 for Unitary Air -Conditioning and Air -Source
accuracy by AHRI-sponsored, independent, third
Ratings followed by a asterisk (*)indicate a voluntary rerate of previously published data, urfess accompanied with a WAS, which indicates an involuntary rerate.
DISCLAIMER
AHRI does not endor e the product(s) listed on this Certificate and makes no represen ations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed 4 n this Certificate. AHRI expressly disclaims all liability for dama s of any kind arising out of the use or performance of the product(s), or the
unauthorized alterati n of data listed on this Certificate. Certified ratings are valid onl for models and configurations listed in the
directory at www.ahi
directory.org.
TERMS AND COND
IONS
This Certificate and i
contents are proprietary products of AHRI. This Certificate shall
my be used for individual, personal and
confidential referene
purposes. The contents of this Certificate may not, in whole or ii
part, be reproduced; copied; disseminated;
entered into a COMPL
er database; or otherwise utilized, in any form or manner or by z
iy means, except for the user's individual.
personal and confide
tial reference.
CERTIFICATE VERT
(CATION
The information fort I I
e model cited on this certificate cn n be verified at www.ahridire
tory.org, click on "Verify Certificate" link
and enter the AHRI C
rtilled Reference Number and the date on which the certificate
as Issued,
which is listed above
nd the Certificate No., which is listed at bottom right.
©2014 Air -Con
itioning, Heating, and Refrigeration Institute
CERTIFICATE NO.:
FMITI40a11
AIR-CONDITIONING, HEATING,
& REFRIGERATION INSTITUTE
We make life twuter,"
131141186282568672