HomeMy WebLinkAbout1609-0195ALL AP�'M= COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Planning and Development Services Building Permit Application
6uflding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax; (772) 462-1578 Commercial
Ides i d e ntia It�
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT LOCATION:
Address: V
Legal Description:
Property Tax ID #:; C1
— V
Site Plan Name:
Project Name:
Setbacks Front—_ Rack:
_Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION _INFORMATION:
rtiona T''111111111 to e e Orme un ert rs permit—c ec
HVAC Gas Tank
a app y:
Gas Pipin 8
Electric Q Plumbing []Sprinklers
_ Shutters
Total Sq. Ft of Construction:
Generator
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Cost Of Construction: +,
�
Utilities:
S Ft. of First Floor;
'-'—
, Sewer �_] septic
OWNERLESS E:
Name r�ltl
CONTRACTOR;
Addre
1i
City:
State:
Zip Codes Fax
Company: If-cti� (A
Addr . s
Phone No —
CityP L
E -Mail:
Zip Code:ggqq � n
Fill in fee simple Title Holder
Phone No
on next page ( if different
from the Owner listed above)
-Mail: (_
State or County License;
If value of construction Is $2500 or more, a RECORDED Notice o
m neement is required,
Lot No,
Block No.
Windows/Doors
Roof
Building Height:
Fax:,
a
DESIGNS
Name:
Address:
City:
Zip: Phone:
ENTAIL CONSTRUCTION LIEN LAW ENI=(
ENGINEER: � Not Applicable
State
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
+IATIO N':
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit
Not Applicable
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 n attorney before
commenci rc or recur I ur Notice of Commencem
_ Signature of Owner/ Lessee/Agent
m c„
STATE OF FLORIDA
COUNTYOF<E•79^�
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this day of: - 20 by
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The forgoing instrument was a knowledged before
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thi�'- day of J Co teffl
C 20 Eby
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(Name of rson acknowledging )
(Name_pf person acknowl
'(Signature of Notary Public- state of Florida )
Personally Known �^OR Produced Identification
Type of Identification Produced
Commission No.�� (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
er --
STATE OF FLOR A,
SEA TURTLE
REVIEW
COUNTY OF - -
The forgoing instrument was acknowledged before
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this day of: - 20 by
M Q
,M o �
I )
A2
(Name of rson acknowledging )
( ignature of N tary Public- State of Florida)
Personally Known L ------OR Produced Identification
Type of Identification Produced
Commission No. _`i' � .d � (Seal)
SUPERVISOR I PLANS
REVIEW REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
Certificate of Product Ratings
AHRI Certified Reference Number: 8215494 Date: 9/12/2016
Product: Single -Package Air -Conditioner, Air -Cooled
Model Number: PA4ZNA048000--**
Manufacturer: PAYNE HEATING AND COOLING
Trade/Brand name: PAYNE HEATING AND COOLING
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME,
MI, 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: R410A AC SPP
Manufacturer responsible for the rating of this system combination is PAYNE HEATING AND COOLING
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): 47000
EER Rating (Cooling): 11.50
SEER Rating (Cooling): 14.00
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 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. 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
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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,
JAM,
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
and enter the AHRI Certified Reference Number and the date on which the
we make lite bet
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.:
131181834 0154E