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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L4 I'/z1 I l -1 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 Address: 6;Z$1-7 1 f7(c�e. WCC d Legal Description: / rnkS QA �,___X)a Y] (�+� Property Tax ID l)oO -- LC Lot No. 0 Site Plan Name: Block No. Project Name: rAQ ► a - Setbacks Front Back: Right Side: Left Side: 11 DETAILED DESCRIPTION OF WORK: .1 N R1 CONSTRUCTION INFORMATION: Fitio a work to e pe orme under this permit — check a that appy. chanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: I L03( Sq. Ft. of First Floor: _ Cost of Construction: $ LCq5.cf, Utilities: —Sewer _ Septic Building Height: Roof OWNERALESSEE: CONTRACTOR: Name Vi V> ► Name: C -CL l©L Address: t City:`�i-� �S�i'L State: �� Zip Code:--34R5Q Fax: Phone No. Address: Merdan /V-o P10 .-2 _'YJL�SLAI City—_I��c+ S f L. gj► E Zip Code:FiiAct$( Q Fax: Phone No.(-1-1Z?�) RnI — E -Mail i State or County License: Stater j • C�r�'i E - Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) if value of construction is 2500 or more, a KtCUKutu notice or commencement a requueu. An ssery (2e555ag'CA Qr�t SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: BONDING COMPANY: _Not Applicable Name: Address: City: Zip: Phone: City: 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 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 COMrTlerIClrl K VVUrK U1 IULUIUIII r, YVLJI INVUI.0 Vi Signature Owner/ Agent/ Lessee Signature of Co or/License Holder STATE OF FLORIDA COUNTY OF S+-, L�-i�t� The forgoing instrument was acknowledged before me th�_ day of .Q 201-7 by STATE OF FLORIDA COUNTY OF '%. L.u,c,t., �P_ The forgoing instrument was acknowledged before me thib?jtday of AQ�X2 20 -L by rQ y Q 22,A % 1 6A'OAI t I (Name of per acknowledging) (Name ofa on acknowledging) "'h :]�iE � (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personal) nown ✓ OR Pr d e Id nt tc ti Personally Known '�#fidi7Cr8 rdiifiicaon __ Y K Type of Identificati ¢ DEBORAH RUSSELL Type of Identifica n x pce 2 i • �' c _ RUSSELL Public tate o oAH Commission No. zs` Comm &w)# FF 179630 ? z* '.` = Notary Publi a o1 Florida Commission No. QS F0 V"'��� y Comm. Expires Nov 30, 2018 ; . .o; Commissidn N1179630 179630 My Comm. Expires Nov 30, 2018 REVIEWS FRONT ZONING SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 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 Ratin AHRI Certified Reference Number: 3588628 Date: 4/27/2017 Product: Year -Round Single -Package Air -Conditioner, Air -Cooled Model Number: RSPM-A043JK 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, Ml, 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: RHEEM RSPM SERIES 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): 42000 EER Rating (Cooling): 12.00 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 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 A 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 www.ahridirectory.org, dick on "Verify 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. ©2014 Air -Conditioning, Heating, and Refrigeration Institute I CERTIFICATE 111 131377688326761(