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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' ar) - (Q m 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: A I G �� D��� o u ­r PROPOSED INPRO_VEMENT LOCATION: Address: z&O 1 Pt Q1 Z' �Lt�. _ Legal Description: '�k_AJC�.nf­l-p (�J� DLA P4A 3 Property Tax ID 1#:' QS - C:) I Site Plan Name: Project Name: ! , Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: AddZe al work to be performed under this permit - check all that appry: chanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers —Generator Total Sq. Ft of Construction: G Sq. Ft. of First Floor: Cost of Construction: $" 1OC� Utilities: _ Sewer _ Septic OWNER/LESSEE: Name _ mP Sleq Address: '-?ql City`?D r-� S�' &i ,5,e_ State: Zip Code: �� �``5� Fax: - -- Phone E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Lot No. -(--)( Block No. l/ a _ Windows/Doors Roof Building Height: Name: C,iZp1� CpnFt(2�-( V Company-, 4 LAT Qk J�S1 R.. (:0 tvcd Address: Sri! t 1.A L L0,PL 93-1,- City: PSL State: rL Zip Code: It q g`c Fax. - - Phone No. E -Mail:'( . State or County Licenserl!121 Q If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name.- Address: ame:Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: _Not Applicable 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 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 yo Y r Notice of Commencement. 6:= Y41natu reOwner/ Agent/ Lessee Xiga—ture of Co or/License Holder STATE OF FLORIDA COUNTY OF S+. L_1 .Ci -4E1 The for ng instrument was acknowledged before me thi ay of 20n by (Name of per4 acknowledging ) 1� (Signature of Notary Public -Mate of Florida ) STATE OF FLORIDA COUNTYOF S-�•L[1Cc�- The forgoing instrument was acknowledged before me t1, 473lHay of O&W 20_0 by C1-�Q 6. i (Name of pers4 acknowledging ) li�x� (Signature of Notary Pua!Ota�te�of F orida ) Personally Known Personally KnownL Type of Identificati ?,Tog nFgngAH RUSSELL Type of Identification Pr d; '`Bl�. DEBORAH RUSSELL � Notary Public - State of Florida 3 j+ U+ Notary Public - State of Florida Commission No. Commiklt" ►' FF 179630 Commission No. r� +g ^(%Oon # FF 179E30 OF F, , ` My Comm Expires Nov 30. 2018 IV . -n Expires N - WO v —! REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 712014 Certificate of Product Ratings .0 AHRI Certified Reference Number: 7845702 Date: 1/27/2017 Product: Year -Round Single -Package Air -Conditioner, Air -Cooled Model Number: LRP14AC36P Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: LENNOX 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: Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC. 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): 34000 EER Rating (Cooling): 11.00 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 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 ww.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. AIR-CONDITIONING. HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at click on "Verlfy Certlflcat " link I,(, - G•and 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. 131299956245946015 ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: