HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: k I I C) �) 2-G Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Des
Property Tax ID #: W I ±l - G 0 b � Z Z - 0,7 p -- -1 _ Lot No.
Site Plan Name:.
Project Dame:.
Block No.
Setbacks Front Back: Right Side: Left Side:
tA- I
Y �'.
Kc
1V) Y'1 r \e (_j V- \ c h .
LJ Shutters
11 Generator
oWindows/Doors
11 Roof
Total Sq. Ft of Construction: S . Ft of of First Floor:
Cost of Construction: $ L4 . 1S5 - bb Utilities: uSewer OSeptic Building Height:
Address: o�
City: jl YC State: �-L
Zip Code: :246ILIq_ Fax: N iA
Phone No. -1-1Z- S5
E-Mail: lJ t\
Fill in fee simple Title Holder on neyt page ( if different
from the Owner listed above)
Roof pitch
Name: &nne-s,
Company:
Address: i)'�1
City:_ } 1� t r Yc C. _ State: V- L_
Zip Code: C' Fax: -71 Z ` 1- 2-2-
Phone
2Phone No. - t
E -Mail: �i�4f',Ity�eSa. (OP cxnk 't,Y" —
State or County License: K -MC) I S
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:. _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip-
Phone:
State:
X Not Applicable
MORTGAGE COMPANY:Nat Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
Commencing work or recording your Notice of Commencement.
,� s
Si ature of Owner/Lessee/Contractor as Agent for Owner 5 tore of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Li�\ COUNTY OF LIC 1�
The forgoing instrument was acknowledged before me
this '�') day of 20 Irby
s I
(Name of person acknowledging)
A
gnature of Notary Public- State of Florida )
Personally Known OR Produced_ Identification
Type of Identificatrorl Produced
Commission No e i '" Ji'c rtatj of Florida
f puri. E7�irL:�l 14,201814
;dy�p,' Ccmmissio�#�FF 71580
h 61 1
Revised 07715/2014
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged before me
this 2 day of _)Qk VL, N y 20 by
(Name of person acknowledging )
ignature of Notary Public- State of Florida j
Personally Known
Type of Identification
Commission No. -- L= —' °` Notary rPSubii - Slate of Florida
MY C0 4�rie ir,; °.iar 14, 2018
Commission # FF 071680
PLAN_`
REVIEV
>
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2016.
AHRI Certified Reference Number: 8676079 Date: 12130/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 4TTR6036J1
Indoor Unit Model Number: TEM4AOC42S41+TDR
Manufacturer: TRANE
Trade/Brand name: TRANE
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, 1L, 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 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): 36400
EER Rating (Cooling): 14.00
SEER Rating (Cooling): 17.00
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 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 wvvw.ahi,idire i-tory.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 6;d4N33MONMG, 1 EAMNO,
CE=RTIFICATE VERIFICATION
RFFRMERATIONINSTiT
The information for the model cited on this certificate can be verified at click on "VnrRy 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.:
ia�2759�as2zs75�s2