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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: -9.0 UM-05TV b - 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: PROPOSED INPROVEMENT LOCATION: Address: I Uc2V .-L nd n 12-ble-C- r, Legal Description: Property Tax ID #: 35a91 Lot No. Site Plan Name: W l I Block No. Project Name: "� c kk�,-'r'L Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: E fl L....) CONSTRUCTION INFORMATION: Additional work to be performed under this permit - check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1 O Cost of Construction: $ 5D g OC7 Utilities: _ Sewer _ Septic Building Height: OWNERAESSEE: CONTRACTOR: Name}' i_I J:L;>n Name: P� Address:—� I `1/� Company o Address: City: l� State: EL Zip Code: c'Fax: �! City: ,� Stater {�-,��nL r$i Phone No. --t-t o5— ��I L.C_ &L- Zip Code: !RL-c Fax: E-Mail: Phone Nd-1--) - ':3 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) i State or County License: t if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. )C. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: — Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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 County makes no representation that is granting a permit will authorize thepermit 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 yoyr Notice of Commencement. ignature,6fOwner/ Agent/ Lessee STATE OF FLORIDA COUNTY OF ��-� . The forgoing instr nt was acknowledged before me I The f§Xing instru ent was acknowledged before me this+ day of 20AI by this f§ d f 2 L—I I e of Florida ) d c jA L Notary PP�ublic - State of Florida = Com=, # FF 179630 Commission No- ;aY P�' OEBO*e®IU�SELL My Comm Expires Nov 30. 2016 ?� •,` 'c Notary Public State of Florida Commission # FF 179630 CPA 19, 1114 pig, _TAFmy Comm Expires N v 30, 2018 ZONING SUPERVISOR PLANS VE REVIEW REVIEW REVIEW R VI W REVIEW REVIEW ignature of Co or/License Holder STATE OF FLORIDA COUNTY OF S+, "Ct.'P— (Name of p n acknowledging (Signature of Notary P lic- Stat Personally Known OR Pr Type of Identificatio ,u Commission No. REVIEWS FRONT COUNTER DATE RECEIVED COMPLETED ev. //2014 ay o 0_ by (Name of p n acknowledging ) (Signature of Notary :�� tate of Florida ) Personally Known Produced Identification Type of Identification Produced This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service A14W goal CERTIFIED ' , , between Feb 17, 2009 and Dec 31, 2016. 'A I Certificate of Product Ratings AHRI Certified Reference Number: 7943220 Date: 2/7/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1648AJ1 Indoor Unit Model Number: RBHP-24 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD 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) installed in all regions until June 30, 2016. Beginning July 1, 2016, central air conditioRegion Note: Central air conditioners manufactured prior to January 1, 2015, are eligible toe can only be installed in region(s) for which they meet the regional efficiency requiremeners nt. Series name: Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, 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): 44000 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 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, OEM so `' personal and confidential reference. CERTIFICATE VERIFICATION AIR-CONDITIONING, HEATING, The information for the model cited on this certificate can be verified at www.ahridirector or & REFRIGERATION INSTITUTE and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,�lck on'Verify Certificate" link the make life bettci"' which is listed above, and the Certificate No.. which is listed at bottom right. ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE Nn - 13130978148263200