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HomeMy WebLinkAboutPERMIT APPLICATION S: All APPLICABLE INVO MUST BE:COMPLETED F6R APPi iCATifSN T E ACCERT6D � Date: Permit Number: �V1.V 0.11 S E -' - Building Permit Application planning and Development Services Building and Code Regulation DN/Slan 2300 Virginia Avenue Fort pierce FL 34982 Phone:(772)462-15$3 Fax:(772)-462,-1578 CQITI:I1'lercial Resi:dential' t PERMIT APPLICATION FOR: P P• ED NPME T Ott. Address: 56 10 P(�ei-Yee O Legal Description. I ViC�i WR 1,NuQ e SEct ke.S I. . ;• Property Tax ID#: 3402- 6 Off- - 02 98 - 000 -.3 Lot No. Z\. Site Plan Name: Block No. t. ProjectNam.e:. Setbacks front Back:... ._. Right Side Left Side:. .. DETa! ED D 'C iP C}N C•}F 11 • R f: -)(_ A rt r,,Lced . A 0d.itionalwor :to bepertormedun,.er t:is permit:=check all that app y: 4. Amecha.nical Gas Tank _.Gas.P ping Shwtters' .? Windows/Do.ors Electric Plumbing _Sprinklers Generator Roof Total.Sq. Ftof-Construction:_ 13� �- q. 5 Ft.of First Floor:. r Cost:of Construction:S .71S ? - 4 o Utilities: _Sewer _Septic: Building Height: Name H(� yl (Z1:3 UPASOVI _ . Name; w1-I'U Ai e� C(9fAC)144r)V1 .a CP i -- - i1 Address: S A t c3 t' C.✓LP V e �1(" Company: ry _1ek+ 1"1_eA1. City: . p�r t. P.i e'Ce-. State: L Address: 5-71. MW P& un w4e. Zip Code:34 0182 Fax: City: I,Gf/f 9{ L1J[i�C' Staten�L Phone No. 77-L �A 6 1 ( 70 L. ;dip Code. 6 Fax: E-Mail:. Phone No. 7.7 2- 00 - PSG Q t Fillin fee simple title Holder on next page(if different E.-Mail:0 f1j]2{,C!�`1 from the Ownerlisted above) State or County.License. _( d�G I (6l.��t.. E: If value of consEruction is 2$00 or more,a RECORDEb Notice of Commencement is:required: :: I 4 S. v .. F _ i DESLGNER/ENGINEER: _:Nof Applicable MORTGAGE COMPANY: _Nat:Applicable I Name: Name: Address Address: i. City: State: City: State.,. I Zi Phone: tip Phone: P=. FEE SIMPLE.TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable k Name; I'. Address: Address City: Cit .. y: Zip:. Phone: Zlp . Phone OWNER/CONTRACTORAFFIDVIT:Application is hereby made to obtain a:permit.to do the work and installation as indicated: 1 I certify that no work.or installationhascornmenced.prior to°the.issuance of a permit: I St..Lucie County makes:no.representation that is.granting a:perrriit will authorize the permit.holder to build the subiectstructure which is in conflict with,any.applicable Home. Association rules,bylaws or andcovenantsthat may restrict or prohibit such: structure.Please consult with your Home-Owners Association and review your deed for anyrestcictions.which may apply. in:consideration of the granting of:this requested permit;i do hei ety agree that f 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 appllcations:are exempt from undergoing a full concurrency review:;room additions,. E. accessorystructures;:swimming.poois,fences,walls,signs, creeh.to*om's and.accessoryuses to another°non-residentialuse WARNING TO OWNER'.Your failure:to_Record a.Notice.of Commencement may result in.yourpaying 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 attorneybefore.. commencing work or recordin o r Notice of Commencement. I I I. Signature Owner/'Age.nt/Lessee Signature of Co or/License Holder i STATE OF.FLORID�j.�, STATE OF FLORIDA COUNTY OF5— ­ 1 f 0 COUNTY OF Lu L',�'� � L'. Th.tf.rgoing:instrument was>acknowledged before.me The f_ofgomg instru nt was acknowledged before me this day of 201 Eby this m day of e,�,20 (e by 0- (Na, e of person ac nowledging:,) (Name of pegs ncknowledging). (Signature of Notary.Pub` -state-of Florida) (signature of Notary Public-StiteofFlorida Personally.Known OR.Produced Identification Personally,Known 1 _ORProduced.identifcation, Y. _ Type of identifies ' Type of Identficatio17100 vPW ; DEBORAH RUSSELL =� 4¢ DEBORAH RUSSELL Co.mrnission No.4 :+ �? Notary Pu&agtate of Florida Commission No. - Notary P�(6�I�al}tate of Florida y Cam Expires, - = = Commission#FF 179630 ?y ' Commission N FF 179630 ",', P ov 30.2018 '%'Favi M is 'anuna . REVIEWS. )N SUPERVISOR PLANS VEGETATION SEA. R L E ` mq COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW i. _ is DATE RECEIVED _.,. DATE l COMPLETED' t -Re—v..71.2014 F 1 e 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 Ratings AHRI Certified Reference Number: 7626354 Date: 9/8/2016 Product:Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14ACXS036-230A** Indoor Unit Model Number:CBX27UH-036-230*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: MERIT 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,Ml,-MN,MO,MT,NR,NE,NH,_NJ, NY, OH,OR, PA, RI, SD, UT,VT,WA,WV,Wl,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 Serres name 14ACX,SERIES LF fx Manufacturer responsible for the rattng,dir phis system combination is LENNOX INDUSTRIES,,INC Rated as follows m accordancewith AHRI'Standartl 210/240 2008 for unitary AIr-Conditlonmg and Air{Sotarce Heat�Purrlp.Equipment and subject to verification of rafing accuracy by AHRI-sponsored, independent,third P arty tesfing t � ¢ r r� Cooling Capacity(Btuh) 34200 ¢h1R-id-14 EER Rating�(Cooling) t 3 c , s s� r 1 Ol}x SEER Rating(Cooling) 16 00 EER`Rating`(Cooling). FootNote 12-This air handler is equipped with an Electronically Commutated Motor(ECM) 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 A ; confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; 'A3 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 L 131178183205085917'„�©2014 Air-Conditioning, Heating,and Refrigeration InstituteRTIFICATE NO