HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1 553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
, La"
Address:
Legal Description:
Property Tax ID #: - �J --5 ' j Q'Z'3q - ooo Lot Na
Site Plan Name: Block No.
Project Name, Ts I ioj� 'v ---v--"'
Setbacks Front Back: Right Side: Left Side-,
DETAILM DESCRJPTION OF WORK:
:'CONSTR
UCTION, INFORMATION:
itis 6 1 work to be IC;rtormed' under this permit — c ec all apply:
N/ 1
LNHVA C Gas Tank Gas Piping fn Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sc,. Ft. of First Floor. -
Cost of Construction: $ Ll C) 1 400 Utilities: Sewer Septic Building Height:
OWNER/LESSEE,
CONTRACTOR,
Marne Tt.) ro'
Name o4 ax
Address,,
Company-. ac 4,L
City.. State:Y�'(L—
Address: 532- �AL) Hlt_-ea-n+J le.,
s
Zip Code:Fax:
City: Pot -4 J -u C States
Zip Code:
�'6 3honeNo,Fax: 77Q '14 q -31S I I
E-Mail:Phone
No. V71 A5W
fill in fee simple Title Holder on next p. agee 'if d"'Ifferent
E -Mail: �40 Q7 rn
from the Owner listed above)
State or County License: C.PtC I %i 16 a3
I - I
IT vame OT construction is,�&)uu or more, a Kt:LUKVtU NOVCe of Commencement is required,
Svrr"'rF*"'LEMENTAL,,CONSTRUCT"--I�UN, -LA��M,'I�NFO.R�MATl�ONl**'I
DESIGNER/ENGINEER: T �Nbt A p
c a b e MORTGAGECOMPANY. Not'l- AppflcaMe
Name: Name:
Address: Address-,
09ty.. State: City: _,c5t a t e,,,
Zip: Phone Zip -P Phone: --
FEE SIMPLE TITLE Not ApplicaMlle BONDING COMPANY: Not AppflcaUe
Name:Name:
Address: Address:
City.. City:_ -
Zip: Phone: ZkP: 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,
St. Lucie County makes no representation that is granting apermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home wners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this re�uestecl permit, I 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 bbsite
before the first inspection. If you *Intend to obtain financing, consult with lender or an attorney before
commenci 0 XAlnr or recordiDZyo r Notice of Commencernept.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument, was acknowledged before me
thisrDS day of ,e4` 20 19' by
fn t V')
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
,(Signature of l`t8`t`a_ry -Public- State of Florida
Michelle Daniel
CM�j' tLlo FI: 90496
RE AU'S7 — PRONT
COUNTER
DATE
TECEIVED
DATE
COMPLETIEDD
RIM
ZONING
REVIEW
SignatuWof Contractor/License Hol er
STATE OF FLORIDA
-�u i
COUNTY OF
The forgoing instry ent was acknowledged before me
thlday of,-- 20 by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub W;: State of Florida )
Corn
SUPERVISOR I PLAN
REVIEW REVIEW
owW,
el- 4411 StaW ot FWWS Q a 1)
MAW y ir W
Michelle Daniel
My CommissionFF906496
::_G�TATION
E I SEA TURTLE K4ANGROVE
REVIEW I REVIEW REVIEW
C A 0
"fi"cate 0.f roduct Ratings
AHRI Certified Reference Number: 201285995 Date : 09-24-2018 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): RA1636AJl
Indoor Unit Model Number (Evaporator and/or Air Handier): 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.
Ratin i RNW&WAS indicate an involuntary re rate The new Dublished rating
that are acco S1 rating
------- is shown.--alonci with the previous (i.e.
v z
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.ahrid!rector!�.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 forthe model cited on this cortific;ite can be verified at www�ahrWlrecteryorg, click on "Vorify CortifiGate" link -vve make 11fe bettec'
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.
131822940382842315
@2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: