HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
��Date: Permit Number:
i
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 I
IPERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT LOCATION:: _
Address:
Legal Description: _. _n 1 e' Yl
Property Tax ID #: �3 `46Q— 1. ()Q— C + Q Lot No.l
Site Plan Name: Block No,
Project Name:
Setbacks Front Back, Right Side. Left Side;
I DETAILED DESCRIPTION OF WORK:
Ce
CONSTRUCTION .INFORMATION:
Ac1clitJDna1_WeMtobeDertormed under this permit-- check all that appy'.
jl .-1I L.�i
VAC Gas Tanis []Gas Piping Shutters ❑ Windows/Doors
11Electric Plumbing ❑Sprinklers 11 Generator . Roof
Total Sq. Ft of Construction; ) j 5Ft. of First Floor:
cost of Construction: $ "T Utilities; Sewer 0 Septic Building Height:
i
OWNER/LESSEE: "
Addre,�-� L)I7__ �M 6\\
City: HCl State:
/'�
Zip Code.. `-7 t�-� Fax: _
Phone No= 4�J-- Z-1 o O�
a
E -Mail
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
CONTRACTOR:
Nam(A)c --,T �ffle,k
M1
Company 1rC V(v C�,�.V lh'" DI'Y,k
Addrs � e' n1e_
\Q) en�
City'l 6;r L _ l e,, State., L
Zip Code:', ';L 4' Fax: S�" US' 3
Phone No. Z- 19— 5-12-5
E -Mail McIn"tri (Ca T ii� CCiY1�C� fli+v , CGt+'>,
State or County License;{, A. _ 5 L_p
if value of construction 15 $2500 or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
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 e first inspection. If you intend to obtain financing, consul end n attorney before
C07V6enci r c or recar I ur Notice of Commencem
�-�— —
s
_ Signature of Owner/ Lessee/Agent w Cn
STATE OF FLORIDA
COUNTY 011 ` .� .qk
�-
� y �
The forgoing instrument was acknowledged before rr
this ��' ay of; C-' c"'�r ':,f . 20 i Ay � g �
/((Namef person acknowled ing17
`.e of Noiary Public- State of Florida )
Personally
Known OR Produced Identification
Type of Identification Produced
Signature of Contr or/License Holder -
STATE OF FLORIDAT
COUNTY OF �`� Lcy— '
w
The s orgoing instrument was acknowledged before m
this_ ay of L' okQj, 20 A by12,
,� a
. 94
Cil I a
(Name ofOrson acknowledging)���`�
(Signature of N`btary Public- State of Florida) ftwe4vw-
Personally Known L_''~ -OR Produced Identification
Type of Identification Produced
Commission Na l—`77 (lJ (Seal) Commission No. 7 �/ �! (Seal)
Revised 07/15/2014 ti
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE l
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 Ratings111111111
AHRI Certified Reference Number: 7174619 Date: 9/6/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 14ACX-024-230A**
Indoor Unit Model Number: CBX27UH-024-230*+TDR
Manufacturer: LENNOX INDUSTRIES, INC.
Trade/Brand name: MERIT
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME,
Ml, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX,
UT, VA, 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: 14ACX SERIES
Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC.
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): 24000
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 16.00
IEER Rating (Cooling):
Foothiote 12 - This air handier is equipped with an Electronically Commutated Motor (EGM)
* Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary cerate.
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 product(s) listed on this Certificate. Al 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
r
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 Uerlrr
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.
02014 Air -Conditioning, Pleating, and Refrigeration Institute I CERTIFICATE NO,.: 131176416544542339