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HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:"`1 1p Permit Number: �lurwiw 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 PROPOSED IMPROVEMENT LOCATION: Address: CONTRACTOR: k_v­CA_ 6ly RCF 3-(q S Legal Description: LcxLce l ono d Po, )(-. -c-t o : t 9 Property Tax ID #: t'35� 0 � (-c l i -- 03'? 3 _ 0 () 0 _ -'s Lot No. Site Plan Name: (Qib 15 t— C- y 1'5( u C1 Block No. Project Name: Setbacks Front Back: Right Side: 14-W Left Side: CONSTRUCTION INFORMATION: Additional work toe pertormed under this permit- check all that appy: ,HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors 11 Electric F]Plumbing Sprinklers E Generator 1:1 Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ c4 (c u `(" SFt. of First Floor: _ utilitiestSewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name X+�-� Lv(.v�� �.�ct`�n Name: Address: c `:� r a �,�fc: G w C( Company: City: EA i Qa,{�_9_ State: EL Zip Code: CI S 1 Fax: Phone No. Address: <;t Xc> co \\ e ^k 5 0 City: L , �� Zip Code: Phone No. '� 3:1 - 4-4 Stater Fax: -1,_3,-) '35 �ZQ,1)'.. - y 0 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: 3 WL_rtkI4 S14 7 (ul. CLO\ , C „ State or County License: C W -N C.. t Z Yp i -116 &c.,.n. �- 9 a. IT value or construction is :�Z5oo or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address City: Zip: Phone: MORTGAGE COMPANY: !Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: i Not Applicable Name: _ Address: City:_ Zip: I certify that no work or installation has commenced prior to the issuance of a permit. Phone: 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 commencing work or recording vour Notice of Commencement. , of Own el"- of l. as Agent for Owner of Contractor/Lidente Holder CTE OF FLORIDA �" STATE OF FLORIDA COUNTY OF .�,-� Li_cc (; [ COUNTY OF �S-+ C -4 C i. 4 , The forgoing instrument was acknowledged before me this "-I day of SPatM�z'a 20 Eby (Name of person acknowledging) (Signa Kr WNotary Public- State of Florida ) Personally KnownOR Produced Identification Type of Identification Produced Commission No. Revised 07/15/2014 The forgoing instrument was acknowledged before me this '-1 day of �+e,jA , 20 to by (Name of person acknowledging) (Sign a of Notary ublic- State of Florida ) Personally Known_ OR Produced Identification Zww of Identification Produced AA.,,,�,._---____ _ JENNIFER MA DOLORES *1_001� MY COMMISSION# mission No. EXPIRES: May 18, 2opw, 0 Nk6------ OINA DOLORES CRISANTE MMISSION # FF994031 EXPIRES: May 18, 2020 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Certificate of Product Ratinas AHRI Certified Reference Number: 8457359 Date: 9/7/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: TC4133621 Indoor Unit Model Number: AP36BX21+TXV Manufacturer: CHAMPION BY JOHNSON CONTROLS Trade/Brand name: CHAMPION HEATING AND COOLING 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: LX SERIES Manufacturer responsible for the rating of this system combination is CHAMPION BY JOHNSON CONTROLS 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): 34000 EER Rating (Cooling): 11.75 SEER Rating (Cooling): 14.00 LEER 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.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. 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; 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 I CERTIFICATE NO.: 1 31 1773449879013,