HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (z 261 Permit Number:
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 McC\10.Y��C0.,
PROPOSED IMPROVEMENT LOCATION:
Address: 0W O
Legal Description: iiAm V w\om 1� t 1 o1Vti s, 10 ( 1-0 A
Property Tax ID #: Z l I 1 � o L - o - (� I] O - q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
L S\c..\WCC tiYx O� \tk-e S ToN R/c, S�SA-Crn, ANF
ku vs mv\ _ OOJn kcy CkY6- W \LVQ e\LctT%C'
CONSTRUCTION INFORMATION:
wor to a er orme un er t is permit - c pec a app y:
�itjiona
LYJHVAC Gas Tank ❑Gas Piping Shutters 0 Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S�F'tj. of First Floor:
Cost of Construction: $ 91.0 u Utilities: I. _ Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CVAAk \
Name: Yv\CS EF
Address: ?-'800 MtIf1S0. T %(•
Company: kAea f�Llf
Address: 3U5 IJ US t} VJ \
City: ]�O Y - -? t -`(f e State: V- ---
Zip Code: Fax:
City: �:ny ?tQ YLr_ Stater
Phone No. :1'12- - A LR I
Zip Code: 3'k'kA (0 Fax: 1-17-- 4 Lo I -9 1 %Z
E -Mail:
Phone No. 1 U L - �6 I
Fill in fee simple Title Holder on next page ( if different
E -Mail: SIASck not \YYkCSCLC a[) • CO)w
State or County Licedse: RNOC) M-_ 0 j
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_X_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 ermit•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
Sign I
urea Less ctor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ST-. t ) C \ E
The for g instr ment was acknowledged before me
thisdi y of dme? AO'l� 204 by
�Z",tnx F
(Name of per on acknowledging)
r
(S' nature of Notary Public- State of Florida )
Personally Known OR Produmd9#00ditp37fbn
Type of Identific ion, dNotary Public - Stale of Florl
2 My Comm. Eaplf.5'.1ar 14, 2(
Commission No., - ',' .. Commissf®eA9fF 071680
Revised 07/15/2014
'"'� S
Signat of Contra or License Holder
STATE OF FLORIDA
COUNTY OF ST V C_\ e—
The forgo' instru ent was acknowledged before me
this day of .030=& 4T9r^ - . 2014' by
��dcr 14: - 4"dcr
(Name of person acknowledging )
,tSignaiure of Notary Public -State of Florida )
Type of
Commission No.
OR Produced
V., u ,PPu--blI c - Stale of Florida
',�(,?�.`4�pim :.tar 14, 2011
wdssion # FF 071680
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal Energy
R, ° Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certified Reference Number: 8868422 Date: 12/28/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 4TTR6061C1
Indoor Unit Model Number: TEM6AOC6OH51+TDR+UF/HRZ
Manufacturer: TRANE
Trade/Brand name: TRANE
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: XR16
Manufacturer responsible for the rating of this system combination is TRANE
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): 58000
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 16.00
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.ahriu irectory.arg.
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,
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.ahridirectary.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
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.. 131274277090118888