HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. -
Permit Number:
ry yr
Building Permit Apph
Planning and Development Services ication
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578Commerawi
--------- Residential
PE I- RMIT APPLICATION FOR: To Select from dropbox, Click arrow at the end of line
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Address: -±±A�CKD
Legal Description: t6l-n
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I certify that no work or installation has commenced prior to the issuance of a permit.
St. Luce Countymakes no representation that is granting a rmit will authorize the permit holder to build the subject structure
wh is in conflict with any applicable Home Owners Assocpe
I lation 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, �', do hereby agree that I willin all respects, perform the work
in accordance w , ith 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 inspect ion.,.If you intend to obtain financing, consult with lender or an attorney before
commencin r reco y
R�dft��wr Notice of Commencement
. 3ignature OT Uwner/ Lessee/Agent
Signature of Itontractor/License Holder
STATE OF FLORIDA I?) 11_
STATE OF FLORIDAJ�
COUNTYOF Irt COUNTY OF
The forgoing instrumpnt was acknowledged before me
this day of
20 17by
(Name of Person acknowledging)
d
(Signature of Notaryy—Public- State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. �4
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
398-0153
The forgoing instrument was acknowledged before me
this --a- L(day o 20 11 by
(Name of person acknowledging
"'(S�igr?ature of Notary Public- State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
LIN g"ARIE BOUCHARCommission No.
6
My COMMISSION #FF1 2552 11
-jN DA VHD
4 My COMMISSION #FF1 25526
1407) 398-0163 F1oridaN0taryService.com
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
REVIEW
DESIGN ER/ENGINEER:
Not Applicable
............
Name*
MORTGAGE COMPANY,
Not Applicable
Address:
Name:
Addresso.
city:
Zip: Phone,
State:
City:
State:
Zip* Phone.
FEE SIMPLE TITLE HOLDER.-
Not Applicable'
BONDING_�
COMPANY:
Applicable
Name:Name,,
—Not
Address:
Address:
.....
City:
Zip: Phone,
Zip* Phone,:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Luce Countymakes no representation that is granting a rmit will authorize the permit holder to build the subject structure
wh is in conflict with any applicable Home Owners Assocpe
I lation 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, �', do hereby agree that I willin all respects, perform the work
in accordance w , ith 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 inspect ion.,.If you intend to obtain financing, consult with lender or an attorney before
commencin r reco y
R�dft��wr Notice of Commencement
. 3ignature OT Uwner/ Lessee/Agent
Signature of Itontractor/License Holder
STATE OF FLORIDA I?) 11_
STATE OF FLORIDAJ�
COUNTYOF Irt COUNTY OF
The forgoing instrumpnt was acknowledged before me
this day of
20 17by
(Name of Person acknowledging)
d
(Signature of Notaryy—Public- State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. �4
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
398-0153
The forgoing instrument was acknowledged before me
this --a- L(day o 20 11 by
(Name of person acknowledging
"'(S�igr?ature of Notary Public- State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
LIN g"ARIE BOUCHARCommission No.
6
My COMMISSION #FF1 2552 11
-jN DA VHD
4 My COMMISSION #FF1 25526
1407) 398-0163 F1oridaN0taryService.com
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
REVIEW
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17,2009 and Dec 31, 2016.
Certificate of Product Ratinas
AHRI Certified Reference Number: 7942888 site: 2/24/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: RA1642AJI
Indoor Unit Model Number: RHIT4821STAN
Manufacturer: RHEEM SALES COMPANY, INC.
Trade/Brand name: RHEEM; RUUD
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, H1, 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 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 (Bfth): 41500
EER Rating (Cooflng)d 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 AHRL 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 h rid I rectory.org, click on "Verify Certificate" link vve make fif� 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.
@2014 Air -Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 1313242735006621