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Home My WebLink AboutCHANGE OUT FORM BARBERALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: NTY Permit Number. - Building Permit Application Planning and Development Services Building and Code Regulatlon Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax.- (772) 462-1578 Commercial -0-0111 Residents a� PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 'PROPOSED IMPROVEMENT LOCATION: LOL Address - Legal Description: L G, + �,y � � -CK - 'V '�3 9 2. Lcj)1 Property Tax ID #: 0 Z - - G, 0 q 0- 1 (2 - m Site Plan Name: Project Name: Setbacks Front Back.- Right Side-, - Left Side: Lot No._ Block No. DETAILED DESCRIPTION OF WORK: ON 4< CONSTRUCTION INFORMATION:, onal--w----or to e ertormed urn er t is permit c, ec a app y: ----- - HVAC Gas Tank Gas Piping Shutters Windows ours Electric Plumbing Sprinklers Generator Roof I __ Roof pitch Tota I Sq. Ft of Construction: Cost of Construction.- $ S. Ft. of First Floor: Utilities:t— Sewer Septic Building Height: OWN1ER/LESSEE.1 CONTRACTOR: lea m e Namea Address: W 13 E',ci--jo Company: rV4 city: +t State: Address: 4�.� doY Zip Code: 349 SD Fax City: Pot -4 S� lucl�e State: Phone No. Zip Code: Fax: E -Mail: _L Phone No. '712, 1 -15 �O Fill in fee simple Title Holder on next page (if different E -Mail-, We_e4_V 0c�xcr v, from the Owner listed above) State or County License: C. All If value of constructinn ir. .47,;nnter m n r m m D r r f% n r% c r% h A. so t I __ — -— — __ — . __ 41 1 0 9 IF a %. 1 11%0%. 1 1 tsw' I I %, la 1 i—_%J %A to %:%A 0 U6 lu LEN ENTAL CONSTROCTION 'LIEN LAWINFORMATIOW UL M �V � U H'i L d FJ I e Name: Address:— City: ��..� �State: _�r� Zip: Phone---- FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address. - city: Zip: Phoifie: r%,&A:ikir!n I #%0%1k19Pr% A &*~4ft9% M mmoonvoiI as� Not AtppnficaUe Name: Address'., City. - Zip: P ho,,ci e c, BONDING COMPANY: —Not Appl�'cab le Name: Address: City:_ Zip' I ----- Phone: %Pvvlv'6n/ %,Wlv I F%M%,1VM ArrIUVII: 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, a do hereby agree that 1 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 w ,Qr� or recordipgyour Notice of Com men cemerf."--�--,,, Signature of Owner/ Lessee/Contra—ctor—as Agent for O�ivner ii:g—na—tu—rto"f�Contractor /�Lice�nse�Holder �' STATE OF FLORIDA - STATE OF FLORIDA P0 ; { COUNTY OF ce, _To COUNTY OF The forgoing instrument was acknowledged before me this day of 20a, by Dav I Name of person making statement Personally Known X OR Produced Identification Type of Identification'—* Produced ,(Signature of 19'6tary Public- State of Florida ) The forgoing instrument was acknowledged before me this/Y day of , 26 LV_ by Name of person making statement Personally Known X OR Produced Identification Type of Identification Produced (Signature of Notary Pub R15 -State of Flo . rida C Wnv __9r"III al) III III III0 IIIIIII IIIIIIII I IIIIIIIIIIII IIIIIIII ,,III I F Comm si 1 4., 7a Of F a al) - Natmy PWAO SWO Of F Mi Daniel '4 WPF O)ioio 906496 Mich 1e Daniel FF My Commission FF 906496 wqnig' _?r -WSW AL IAL AL 111111111111 1111111 RE' 'd, �1 , 1. F "ON ' i N G SUPERVISOR PLANfv%VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 This combination qualifies for a Federal Energy Efficiency tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Co%rt'f' te of roductK"atiunas v i ica AHRI Certified Reference Number: 201285995 Date : 09-14-2018 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 and/or Air Handler): RH1T3617STAN 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 : 35400 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 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. Retinas that are acqgMpanied-by WASindicatean-,involuntaU-.re-rate.The .--,new ,Qublishgd, rating, is.shown -al n with the Rrevious i-2.WAS ,).ratio DISCLAIMER m 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; 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.ahridirecfor y.org, click on "Verify Certificate" link we 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. @2018Air-Conditioning, Heating, andRefrigeration Institute CERTIFICATE NO..' 131814074472036251