HomeMy WebLinkAboutBuilding Permit ApplictionALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Q Permit Number:
J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED INPROVEMENT LOCATION:
Address: % Li^) (6 `- I �j
Legal Description: —4-4--( n`l-i s 4- 1GL44-
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be rtormed under this permit — check all apply:
✓HVAC Gas Tank EGas Piping Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: qt:::(D Sq. Ft. of First Floor:
Cost of Construction: $ .' �3Lo S�- UC) Utilities: []Sewer 0Septic Building Height:
OWNER/LESSEE: 0 _ctr(-1ztala,
Name C
Address: I ri
City: _ _L_[J ��, , ni State: FL
Zip Code: 331055 Fax:
Phone Not -7--7n,'-1
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: PATRICK FLETCHALL
Company: COOL 8 RELIABLE AIR COND
Address: 1051 NE SANTA CRUZ DR
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 772-692-5750
E -Mail: r_cool@bellsouth.net
State or County License: CAC058567
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
IM
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
— Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State: City: State:
Zip: Phone:
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable BONDING COMPANY: _Not Applicable
Name:
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 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
commencin work or recor nQ your Notice of Commenceme t.
SigCofo
wner/ Agent/ Lessee ature of Cont or i ense Holder
STATE OF FLORIDA STATE OF FLORIID-.14,
COUNTY OF �< c f_'_ COUNTY OF
The forgoing instrument was acknowled d before me
t j day of �G ✓r(f7 _ 20on by
(Name of person acknowledging I
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(Signature of Notary Public- State of Florida )
Personally Known ` OR Produced identification
Type of Identificati
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Commission No. :?
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Notary Public -
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Commission it FF 1?17091)no
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Revised 07/ 15/ w ,`�� s •• ��;
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REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
The f rgoing instr ment was acknowledged before me
thi;rday of ' 20Z]by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of IdentificaDEBO ®
p�PpV P�4,
H RUSSELL Commission No. '2°. .`c:{�USSELL
_. otary Pub is - State of Florida re
State of Florida Commission FF 179830
My t;omm. Expires Nov 30, 2018
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
Certificate of Product Ratings
AHRI Certified Reference Number: 7493626 Date: 6/21/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: RA1424AJ1
Indoor Unit Model Number: RBHP-17
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): 24000
EER Rating (Cooling): 12.50
SEER Rating (Cooling): 15.00
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 cerate.
DISCLAIMER
AHRI does not endorse the products) 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 u�'
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 whale or in part. be reproduced; copied; disseminated; OEM an `i
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. &REFRIG RATIN HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at click on "Verlfy Certificate' link nal:e llfc
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
131425389270676121
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: