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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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
PROPOSED IMPROVEMENT LOCATION:
Address: _ jU,�00
J. u t 1 V:54 uo — .0
„l l:4�C
fir. -,
COUNTY
F L O
R I D A
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
PROPOSED IMPROVEMENT LOCATION:
Address: _ jU,�00
J. u t 1 V:54 uo — .0
Yenwn Eek 11 -�1
Legal Description:
A Unit
0.Vk� F(0-kcLJ-\ VIar-C, th
eMmofl Ekm'014S
Property Tax ID #: ovy— g
Site Plan Name:
Project Name: 4)i (-( 3 J a.0
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK ,
Lot No._
Block No.
ou t- A, �0 L iorl{A 40 -Xtj
mode( * RA IN30 RajjAfi3�1`jSt k)sr4
CONSTRUCTION INFORMATION:
AUd—j itiona wor to ffGas
r orme un er
2 HVAC Tank
11 Electric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
ffis-t - c ec < a app y:iping _ Shutters
Sprinklers 1-1 Generator
S Ft. of First Floor: _
Utilities:[]Sewer OSeptic
OWNER/LESSEE:
Name (4-r•
Address: IOZ 0 S, Xfow br,
City: 1 -co sen & ac$ State: rL
Zip Code: q`�j� Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Windows/Doors
Roof Roof pitch
Building Height:
Name: ,P) i r -,C1 e -,V --
Company: S P-6 AQ, fk X11 C C U C,
Address: 5-'`'1 n -co m ffaja +t L� e L w i
City: b,(T- 54--. LjAopgf State: 4::7 L --
Zip Code: y-IIZU Fax: 1-7a -6134 -35 1 I
Phone No. -7-7
E -Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required,
DESIGNER/ENGINEER: _ Not Applica
Name: _
Address:
City: _
Zip:
Phone:
State:
MORTGAGE COMPANY: ` Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 Count 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 rf+`or recording4aur Notice of Commencement,
_ Signature of Owner/ Lessee/Agent
Signature of Contractor,
STATE OF FLORIDA/ STATE OF FLORIDA
L
COUNTY OF rt S+, Q L C� COUNTY OF W— S4,
The forgoing instrument was acknowledged before me
this _0 day of 4P c (-- , 20 l=7 by
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known '� OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
388.0153
The forgoing instrum nt was acknowledged before me
this �� day of 21 L , 20 /,7 by
(Name of person acknowledging)
6&a P/It/J
Ig ature of Notary Public- State of Florida )
Personally Known � OR Produced Identification
Type of Identification Produced
LINK"ARIE BOUCHARq I Commission No.
MY COMMISSION #FF125526I
1407)398.0153
JNDA MAI01141bUCHARD
MY COMMISSION #FF125526
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
AHRI Certified Reference Number: 7491226 Date: 4/10/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: RA1430AJ1
Indoor Unit Model Number: RH1T3617STAN
Manufacturer: RHEEM SALES COMPANY, INC.
Trade/Brand name: RHEEM; RUUD
Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA
AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ,
NY, OH, OR, PA, RI, SD, UT, 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 (Btuh): 29400
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 15.50
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, AM
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.ahridirectory.org, click on "Verify Certificate" link we make life heti—I
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
__.__.__ __ __ _
which is fisted above, and the Certificate No., which is listed at bottom right. __.__..... _..___...._............
©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131363176574424107