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HomeMy WebLinkAboutBuilding Permit Application j d ALL APPLICABLE INFO MUSTBECOMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:'-. l 0U 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 IM,PRQVEIVIENT LOCATION Address: 'oil/ ,. Legal Description: f/245 /KQ Property Tax ID#: 33v2wX- ,,SDS' O/74 ' me—� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Sidi: C DE [LED DESCRIPTION OF WORK Gt1 �itr :Seer f"D� � CONSTRUCTION INFORMATION : Md1t10 ewor to e orme un er t is permit—c ec a appy: C Gas Tank E]Gas Piping _Shutters Windows/Doors Electric Plumbing Sprinklers El Generator Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floo : Cost of Construction:$ ���� Utilities: _Sewer Septic Building Height: bWNER/LESS'EE: . CONTRACTOR Name �2r ' Name: ' 1•_ Address ti!/ Company: cC City: St ate,� Address 3cI SZiJ1''' �ts ///�/] rte" Zip Code: LLd.Sr4� Fax: City: r! �]_ LcJG�' ' State'` Phone No. :570 ' &6.3` Q' 9 Zip Code: ,���'S'j Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: Z from the Owner listed above State or Cou ty License: ; if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ' 'SUPPLEMENTAL CONSTRUCTION LIEN-LAW INFOMATIO.N: 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: 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 afull 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 commeKing work or recording our Notice of Commencemen 16 Z"' -- s Sig ure of Owner/Lessee/Contra as Agent for Owner Sig ature of Contractor/License er STATE OF FLORIDASTATE OF FLORIDA ' COUNTY OF - A-V ci' COUNTY OF S*f The for oing instrument was acknowledged bfore me The forgoing instrument was acknowledged before me this day of '�^ !J� 20by this day of 20 by D (Name of person acknowledge (Name of person acknowle ng) Qj.�. (Signature of Notary PubliciState o lorida) (Signature of Notary �Publ�ic- tate of rida Y , ) Personal) Known OR Produced Identification Personally Known " OR Produced Identification Type of Identification Produced Type of Identification Produced Commissi d;&. CAROL A.WEAGLE ""YP!•� CAROL IIVYEAGLE' - Seal Commission N�'. ••••• rrSS al•-- i* ' =' =�=MY COMMISSIONFF 094208( ) MMISSION N FF 09420 ^ .�. •' EXPIRES:April 5,2018 EXPIRES:April 5,2018 r�rec�Fl. , 9ondedThruBudget otaryerv¢r, reaF<oa Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I I I 117' This combination qualifies for a Federal Energy Efficiency tax Credit when p placed in service between Feb 17,2009 d Dec,:31, 2016. CERTIFIED www.ahridirectory.org i 2rti icate ofProductRatingiI g AHRI Certified Reference Number:201631373 Date:01-12-2018 Model Status :Active Old AHRI Reference Number :7512350 AHRI Type :HRCU-A-CB Series r i i Outdoor Unit Brand Name :RHEEM i C Outdoor Unit Model Number (Condenser or Single Package) :RP1542AJ1 Indoor Unit Brand Name I Indoor Unit Model Number(Evaporator and/or Air Handler) :RH1T4821STAN ' i Furnace Model Number i The manufacturer of this RHEEM product is responsible for the rating of this system combination. I i; I I � Rated as follows in accordance with the-latest edition of ANSUAHRI 210/240 with Addenda 1 and 2,Performance Rating of Unitary Air-Conditioning 8 AirSolirce Heat.Pump Equipment and subject to rating:accuracy by AHRI-sponsored,independent third'p rtytestmg: , 1. Cooling Capacity(A2)-Single or High Stage(95F),btuh.:42500 (I: SEER:15.00 I I, I ' EER(A2)-Single or High Stage(95F)W:-12,50 Heating Capacity.(H12) 'Single or High Stage(47F) :40000 HSPF(Region IV) :9.00 ,l 4i, + I t"Active"Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are being marketed but are not yet being produced"Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. i 1 Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the previous(i.e.WAS)rating. 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 6r' 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 CONDITIONSAM M 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; A 0"i-4'� 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 ,e mal a life better- whichenter 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. ti a ©2018Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO:': 131602444511955060'