HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Elate: 6 ° (2 ` Ls...,._. Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierre 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: 11
Address: -_LAS QLAS DR, M -KE -3F -b F)EACE EL 34952____—
Legal Description:zE.Lu ULLB I Q N OWE, --
Property Tax ID #. 11- 5 D 2 - 000 - 2 Lot No. 21
Site Plan. Name: PA NSTA�b D R, -- Block No_
Project Name: I i
Setbacks Front
Back. Right Side; Left Side:
REMOVE F RCTLACF. EX)5-TING A)C E IkIPMEEK-1 FOR NEW Ruu.D, R410A,
5 -YON AIH W I -TI -1 5 KW ELC_CTRI �- 1AF-AT, MIA -L4 R" 1 P 307
3 TbN CCS. , MZ00�-L4 RAi4-56 AZI NAl No DLLC.'T WORK . JA--- 5F -e
CONSTRUCTION INFORMATION:
Aaditional work to be e orme un er t is permit -- c ec affS=ers
HVAC Gas Tan% 0Gas Piping O Windows/Doors
l=lectric Plumbing OSprinkiers Generator Roof Roof pita,
Total Sq. Ft of Construction: _JI_, S . Ft. of First Floor:
Cost of Construction: $ — -� 333 , Utilities. Sewer F]Septic Building Height;
OWNER/LESSEE:
CONTRACTOR:
Name LO N A
Name: 1 H b M A5_ % CA„gdL POOL.
Address: r"I 1 _ S , LAS QL65, DR. _..
--R'\/
Company. c, —
Address:43 51 SE Dl Xl E R 055 ST,
city: ? C --N ST --N CIH state: F t-
zip Code= 34-951 Fax: \
Phone No_r I7 2- b I '
City: ST LLA state:FL
Zip Code: 34q q r7 l=ax: T72-2 9.lb-ID116 4_
Phone No. -'I -I?,- 2 tp -2144-
2'.1 4 -
E -Mail: A d ?- @ an , czy”
Fill
Fill in tee simple Tdie Holder on next Page ( if different
E -Mail; P Q I C'my, e
from the Owner listed above)
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State or County license: LAC, i ?�, 1 "15 (D 5 _
.. �Q•�� ... rv�wu •+�uv1■ ■.? -pm oVu Vl lfiiuiu, c, mume or uummencemenr is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
City:_ -
Zip: Phone:
Zip: Phone: T
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
commencing work or recording your NAice of Commencement.
Signature
s
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA -
COUNTY OF _ ; \ac- -b-/' COUNTY OF {`tl
The forgoing instrument was acknowledged before me j The forgoing instrument was acknowledged before me
this iC�{ day of _ ' _ri e 20 � by II this a- \ day of '7 20 1-1 by
c"r')) i`J. C>t3I -A-V\c"i'ACXS !�, A-LRC--fS _
(Name of person acknowledging) (Name of person acknowledging )
(Signtura.o Nota Public- State of Florida S�na u e-olf Notary Public- State of Florida
r Notary } (� ry }
Personally Known ORI
Type of Identification Produced
Commission No.
Revised 07.
uced Identification ,/
1<464IXI$OTTERN
Notary Public - $tate of Florida
My Comm. Expires Jan 10, 2020
Personally Known OR Produced Identification
Type of Identification Produced _]b'r-�ye- S
Commission No.
KARRY BOTTERN
Notary Public - State of Florida
Commission # FF 948940
My Comm. Expires Jan 10, 2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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 Ratings
AHRI Certified Reference Number: 201285995 Date: 06-06-2018 Model Status: Active
Old AHRI Reference Number : 7942207
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package) : RA1636AJ1
Indoor Unit Model Number (Evaporator andlor Air Handier) : RI -11 T3617STAN
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, Hl, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, 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.
The manufacturer of this RUUD product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSIIAHRI 2101240 with Addenda 1 and 2, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 35400
SEER: 16.00
EER (A2) - Single or High Stage (9517) : 13.00
t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or aftenng for sale; OR new models that are being
marketed but are not yet being produced."Production Stopped" Mode] Status are those that an AHRI Certification Program Participant is no longer producing BUT is stili
selling or offering for sale
Ratings that awe accomarned b INAS indicate an involutar�rete mTheewubl�shed ratter is shown along with the previous (i ewAS} rutin
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.:..usa: r'seilrecterq.er_,.
TERMS AND CONDITIONS mom
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 userrs 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 -.1ww.ahridirectory.org, click on "Verify Certifica- ::" link 'ew 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. - --
02018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO,: 151727734343836477