HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA E INFO LI5T 8E 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,.�
Residentiai
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT LOCATION; :.
Address: Allio
�lio
_ 3� `
Legal Description: cr`i`{
Property Tax ID #: /� - %� a�� ' -a..
Site Plan Name;
Lot No.��
Project Name;
Block No.
Setbacks Front Back: __- Right Sider Leff: Side:
DETAILED DESCRIPTION OF WORK:
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11
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CONSTRUCTION INFORMATION:
Ilion or #o e e Orme un er rs perm t—c ec a aPp Y
HVAC Gas Tank alas Piping Shutters
Windows/Doors
Electric Plumbing OSprinklers Generator
Roof
Total Sq. Ft of Construction
5Ft. of First Floor:
Cost of Construction: $ ' Uti[!ties-nSeweeESeptic Building Height:
OWNE-RXIL.ESSEE: s CONTRACTOR:
Name Ili l '" �l Narne• r
Address dd �PtY,
City: 0 i. l � �� #, ti r I' n
_ State: -YY ct�dr is,; 4
Zip Code: 3 - Fax:
Phone No. / p is .;' , City: I �� Stater .
E -Mail: Zip Code,,;I Fax:
Phone No.�—G.
Fill in fee simple Title Holder on next page { if different
-Mail: CA -
from _
the Owner listed above)3
State or County License:
If value of construction Is $2.500 or more, a RECORDED N of Commencement is req ui d. s
flli'1C�C,�1�10 ,'1 cc �4 i'Ut1GlC�C����>7� e.S .
Name:
Addre!
City:
Zip: _
(NEER: — Not Applicable
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 a first inspection. If you intend to obtain financing, consujtwithAef n attorney before
co Cenci rc or recor I ur Notice of Commencem
Signature of Owner/ Lessee/Agent r_ «,
STATE OF FLORIDA o vis
COUNTY OF
The fo instrua3ent as acknowledged before o o
this day of/ ! 20 y -2
r U � CYJ
�`Y111iNiilfl'
(Name pf person acknowledging)
'(Signature of Notary Public- State of Florida )
Personally Known Ll_� OR Produced Identification
Type of Identification Produced r
Commission No. l `7— 1 -7 (Seal)
,,(j
Revised 07/15/2014
Signature of Contrnttor/License Holder
STATE OF FLOR A
FRONT
COUNTY OF -
c
PLANS
VEGETATION
The Toro instrument
as acknowledged before m i'
this,�,`.�`' day of t
20 ) by !
REVIEW
REVIEW
REVIEW
FE
(Name of rson acknowledging)
REVIEW
�wlre�,y
(fignature of N tory Public- State of Florida )
rrllul�
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. _ (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
BATE
COMPLETE
INITIALS
Certificate of Product Ratinas
AHRI Certified Reference Number: 7493626 Date: 7/24/2017
Product: Split System: Air -Cooled Condensing Unit, Coif 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 regions) 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 2101240-2008 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 (Btl 24000
EER Rating (Cooling): 12.50
SEER Rating (Cooling): 15.00
IEER Rating (Cooling):
' Ratings followed by an asterisk (") indlcate 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 products) 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 Cal 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 Al 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; rl'
19
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, click on "Verify Certificate" link rove make Iife 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. 3145g8852��751 I
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: