HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COfV PLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
uilding Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 314 ;2
Phone: (772) 462-1553 Fax: (772) 2-1578 Commercial Residential
PERMIT APPLICATION FOR: f6 Select from dropbox, click arrow at the end of line
Address: KAW a_ -k T
L e g a I
!e s c r i p t i o
Property
Site Plan Name:
Project Name:
Setbacks Front Back: I I Right Side: Left Side:
DETAILED DESCRIPTION OFW:ORK-.
Lot No.
Block No.
Additional work to be ertormed under this permit —check all apply:
FM
r.
LNHVAC Gas Tank [:]Gas Piping Shutters 11 Windows/Doors
11 Electric Plumbing Sprinklers E:] Generator Roof I Roof pitch
Total Sq. Pt of Construction:
Cost of Construction: $ 0)_00 00
Sq. Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR.
Name Kanea
Name
address. K' 'k, lt:_Ct
I
Company: AC '�'ew vic
City: furf State:'- L'1_
Address: 532- kreckn+1 16
Zip Code: 71W r11 Fax:
City: PoL4 �Cy State'17)
Phone No,
Zip Code: 3q 9 g (2Fax: Sq 3S 11
E -Mail:
Phone No. 1_ Z- A5
Fill in fee simple Title Holder on next age if different
E -Mail: ;4(1 E_Wee�Vsctrvi C-e & C0_M_
from the Owner listed above)
State or County License: Chc I
If value of construction is $2500 or morn, a RECORDED Notice of Commencement is required.
SUPPLD EN'--.! L CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY0 Not AppkabQe
Name : Na m, ,
Address:_... State: City: State:
Zip: Phone Zip: Phone. -
FEE SIMPLE TITLE HOLDER. Not Applicable CC0hjhPANY: —Not Applicable
Name: Name.--
SS
Address: AddrD e
City: City -
Zip: Phone-.-- zip.. Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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.
I
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 0wriers Association and review your deed for any restrictions which may apply.
In consideration of the granting of this reC,Uested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, thl 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, fer ces, 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 jobsi e
before the first inspection. If you 1 tend to obtain financing, consult with lender or an attorney before
commencinjzwQ&orrecordinRy_11 Notice of Coe.
01 mmnceMqr�
Signature of Owner/ bessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF flc
The forgoing instrurpent was a,pknowled0ed before me
this d a y of >4 e -).-, b 20-4 by
''DC'ki/V I
Name of person making statement
Personaliy Known X OR Produced identification
Type of Identification
Produced
Signature of dtaory Public- State of Flqrlda
F
wtory pow - — -
Michell,
e Daniel
F 9,06496
RE\M97r'w FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signatur�of Contractor/License Holder
STATE OF FLORIDA
, C) -
COUNTY OF k 0C
The forgoing instrument was. acknowledged before me
this,I' d a y o f � &F �,K_I I by
--= 20
I
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub E6 State of Florida
r�w _W'W 'W 'W
Comm S1 0
N'Dtary pume eta% of a
FWMS
Michelle Daniel
My Commission FF 906496
ib'Wl� f G SUPERVISOR PLANS-- VCGETATION SEA TURTLE MANGROVE
� I REVIEW REVIEW
REVIE REVIEW REVIEW REVIEW
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Cert'ifi"cate f roduct Rat"ings
AHRI Certified Reference Number: 201281652 Date: 09-21-2018 Model Status: Active
Old AHRI Reference Number : 7941343
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser o - Single Package) : RA1 630AJ 1
Indoor Unit Modei Number (Evaporator and or Air Handier): RH1T3617STAN
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, H , ID, IL, lA, lN, KS, KY, LA, MA, MD, ME, Ml, MN, MO, MS,
M11%_
� 9 INC, ND, NE, NH, J, NM, NV, NY, OH, OK, OR, PA, dal, SC, SD, Ti�l, TX, UT, VA, VT, WA, WV, Wl, 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 Unitanj
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 29000
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. "Prod ucti n Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Rafipg[a thaLtare —ac-c—Qm-paniLed—by--WAS -Lndic-a-te�—a=ntaw-re-ra 4��t The new blished rating s shown alona with the xevious (i.e. WAS) rating.
_t __ - _Pw
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 Cevtiflcate. Certified ratings are valid only for models and configurations listed in the
directory at
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHM, This Certificate shall only be used for hidividual, personal and
confidential reference purposes. The contents of this Certificate rnay not, in whole or in pant, 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 certifiqate can be verified at www.ahridIrectory.org, click on "Verify Pink we make life bc-tteem
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
which is listed above, and the Certificate No., whit is listed at bottom right.
@2018Air-Conditioning, Heating, an Refrigeration Institute CERTIFICATE NO.: 131820331869633778