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Home My WebLink AboutBuilding Permit ApplicationALL APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:/I Oro /2£)/f..£;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 X• PERMIT APPLICATION FOR:To Select from dropbox,click here Address:&0 I \S.ndla/.0 i Ve/2.'yr; Legal Description::2J~J 5~N 10 rr OF E 8f(q ET 0;::~105'7 a-Or AI e770- Fr OF Boa tQT '1-WLTH RIP 87S (oR \.31'7rJ -Jb9q) Property Tax ID #::II/db -L/;3 -crtJI-000 -1 Lot No.zt Site Plan Name:_ Project Name:_ Setbacks Front _ Block No,_ Back:Right Side:Left Side:_ Shutters D Generator o Windows/Doors DRoof Total Sq.Ft of Construction:_--=,-----_ Cost of Construction:$_'CL-'JftfJ....<..:"'-I.L.._fi2 _ S~of First Floor: Utilities:USewer DSeptic Building Height:_ Nam ~ Address:\3~=-~~~~~~~~=-~~~- City:kl2/~&e' Zip Code:0'f9&2.Fax:r-:=--_ Phone No.7'7<2-lco7-1f}33 E-Mail:_ Fill in fee simple Title Holder on next page (if different from the Owner listed above) If value of construction is $2500 or more,a RECORDED Notice of Commencem "SUPPLEMEi:JTAL CONSTRUCTION LIEN LAw INPORMATION:.."'. '.-.,,"."--..-" 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie countx makes no representation that is granting a permit will authorize the germ it holder to build the subject structurewhichisinconllctwithanyapplicableHomeOwnersAssociationrules,bylaws or an covenants that may restrict or prohibit suchstructure.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 your Notice of Commencement. lv'<~~//:11~1~VJ<-~~7f2~~ $Igrfature of Owner/Agent!Lessee /Slgnature of Contractor/License Holder STATE OF FLORI~d LuCr'u STATE OF FLORIDA ~'.Utc;C)COUNTY OF U COUNTY OF '<,(}an1 Th~~ng instr'Aftn~owled~efore me Th~"g '""'Ak,"l was t:~;wledged beforemethi~aay of V ,20 /k by thi _Clayof avcft..,/,20(]fJby cS.(}(rIcrel T 0lrfAuJ((I{2mllelT())tt rho A'# (Name of person acknowledging)"'-(Name of person acknowledging)<, /P.yJ;\\lIItIl':/l'I/1. ~_L>Pa_L.A I ..\\\\lillll/II"-_.•••/Tj(F./,,_ (Signature of Notary~~~f§f Fr~~(Signature of Nota7-Stat~$~:istiJj ••-:"%~, ~~.·~'i.I'IRES --,0~ Personally Known -::'?d:R Prof.l~~q,~~ification Personally Known oRt&~;"~~ntifici\t~ Type of Identificatiod:~<%d 4"~;H~§---Type of Identification Product3lw :~;:,'0'%~'6:::; ~;&:\<0 ~/I ~~••..0~:~:::z~•k ~~:ll.J=~2.·o~'~<::)b'§.t--.::::~--fA "~Commission No..~•••07,~(te~~/~~Commission No.~~'.J ",~.'~):;.~••••••••~'\~\S~.~010.'4 ~~Q'"~J~: ~•••~()~.o ~~'flllii/<NOTI\~\\",\;~........~(')\.~\,~ -"1111 ,/XOT,A\:;\\\'''' Revised 07/15/2014 11////111\\1\\ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED A.~91CERIIFIE[)® www.ahridirectory.org Ce ifica s AHRI Certified Reference Number:8456855 Date:11/21/2016 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:TC4B3021 Indoor Unit Model Number:AP30BX21+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,10,IL,lA,IN,KS,MA,ME,MI,MN,MO,MT,NO,NE,NH,NJ, NY,OH,OR,PA,RI,SO,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 COolin~rCapacity (BtUh): ManufclC::t~rerrespol1siblefor the rating of this system combination is CHAMPION Rated CiS follows inaccordance withAHRI Stal'1dard 210/240~2008for Unitary ~~~~~,~6~!~~~~~~;~'~fn~j~~[~~~~~~~ceHeatPcl!mpEquipment and subject to.verification of rating accuracy,by AHRI-sponsored, party t~sting: "'1EER Rating (Cooling): <~''f:.::C»",';<:,,''--e "'"c SEER Rating (Cooling): lEER Rating (Cooling): 29800 11.75 14.25 "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. CERTIFICATE VERIFICATION 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 certificate was issued, ;;~~~s:i:_~~~e~;t~:~i~~r~::t;i~;::~:~~;~~;;~:;:::;~;;;tute ~'-;C-'~RT'FItATE-NO.-~----------------- AIR-CONDITIONING.HEATING, &REFRIGERATION INSTITUTE \VI:.':make life better" A.~!!!ICERTIFIED® www.ahridirectory.org Certificate of Pr duct Ratings AHRI Certified Reference Number:8456855 Date:11/28/2016 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:TC4B3021 Indoor Unit Model Number:AP30BX21+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,10,IL,lA,IN,KS,MA,ME,MI,MN,MO,MT,NO,NE,NH,NJ, NY,OH,OR,PA,RI,SO,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"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 LX~ERIES .. Manufa~turer re:pon~ible for the rating of this system combination is CHAMPION BY JOHNSON CONTROLS ~;;>:,>::':<_«:_.:_,,:::'_.',:.-:.____"'.'._,.,..:·:··-t ___.".>,y<'.(--:_-:_-_:"_~:-r:-):_>_---'-,~::"__.,:,. Rated as foUows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditi<iiiing.and'Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent;·thirdpartytesting:.... ~Cooling Capacity (Btuh):. EER Rating (Coolin9):. SEER Rating (Cooling): 11.75 14.25 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 productts),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. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.orgv click on "Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, ;;~~;s~~_~;~e~~t~:~i~~~r~::t~~;::~~h ~;;~~;;~:;;:~Ir~g;:;tute FBJ~~~i~~-;'TENO.:-----131248333208082698 AIR-CONDITIONING,HEATING. &REFRIGERATION INSTITUTE we make tife better"