HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.- Permit Number
64, 6M
- ------
Buflai 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 IMPROVEMENT LOCATION,
'q
Address: ;J
?
' L"_ s'
Legal Description,: C P�
0-7)
Property Tax ID #: — 009 0amara '...ot No.
Site Plan Name: Block No.
Project Name: n cz 4,u
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Ck
f ILC/ �4CLI
_i� C
r
c"Y � t
..CONSTRUCTION IWORMATION,
AWitio-fial work to be i0o rtormed underthispermit --c-h-e-c-ckall, apply -
R71
LNHVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5P 3 S 40 0
ScV Ft. of First Floor:
Utilities: :]Sewer Septic
Building Height:
OWN E RAESS E E
CONTRACTOR.
Name ')
ct"k U 1_(_(
Name, 1.) 9'
Address: Ll (Y) OA LUL44--- P'�IXompany-
**,. � E��A'q ac iii C"('
+ ale
city: State:
Address: 532 -_eckn I
U.Q,( LI LI 1
Zip Code: F a x
city: Pot.4 s�,- ki C , L -C state,,
Phone No.— coi — "'o -co:
Zip Code: Fax.,
E -Mail:
Phone No. '11z__ 1 45W
fill in fee n simple Title Holder onext page ('If different
E -Mail: (i(40 V,
j Co. rn
from the Owner listed above)
State or County Licenses .C.hc I %i I 6a3
it vaiue of construction is;�Z5UU or more, a REQ UKDED Notice of commencement is required.
a
FEE SIMPLE TITLE HOLDER., Not Apphcabll,-e
Name-,
Address.-
0, t �' 1:_
13
Z�pd Phone:
qFORMATION!,
MORTGAGE COMPANY-.
Not ApphcaUe
Name:—
ddress'_.._....� --�_.�.x�a.
A.,
x_..-u-.-..�c.. us-._cc_..ar_� -�_ x..�z�.a�
s
cftyb6
_ pp f
Z'1 P -t
.0
-B7Y.
ONDING COMPAN
Not AppkaUe
Name:
Address:
City..
zip.. Phone-,
OWNER/ CONTRACTOR AFFIDVIT,', Application is hereby made to obtain a permit to do the work and lnstaiiaticn 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
commencina wood or recordin vQur Notice of Comm en ce meyff7'��,
Signature of Owner/ Lessee/Contractor as Agent for Owner SignatuWof Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for ging instrument was a nowledged before me
I
thisl.LLdayof 7
20_Li by
Name of person making statement
Personally Known - X OR Produced Identification
Type of Identification
Produced
x"
,(Signature of Pt8t`ary -Public- State of Florida
(Spao
Notoly
Daniel
901496
R E\ArV75" 1W - -FRONT I'ZO`NING
I COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The forgoing instrurnent,was , cknowledged before me
this 1-F'"day of 20_11_ by
)0V
�:
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary PubW;: State of Florida )
�r 1W _W W _W Im W W al)
Comm sl %or -to of FJOWS
fttry pw*o
Michelle Daniel
My CommissioFF 906496
SUPERVISREVIEWER I REVIEW PLANS-- I [ VEGETREVIEW ATION y I SEA REVIEW Ev6
LE MWVE
I
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 31, 2016.
Let
AHRI Certified Reference Number: 201285855 Date: 09-10-2018 Model Status : Active
Old AHRI Reference Number: 3588628
AHRI Type: SPY -A
Series: RHEEM RSPM SERIES
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RSPM-A043JK
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, 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 ANSI/AHRI 210/240 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 : 42000
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 12.00
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.
Ratin@s that are accomganied by WAS indicate an inXoluntaU re -rate. The new gublished rati !s shown
with Q
,the grevious .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 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
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; AIGH
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.ahridirectury.arg, click on "Verify Cortif icate" link Nve make life betterT11
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.
@2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131810673609794462