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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO/ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: / -aro f(¢ Permit Number: UWA • Building 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: Address: ! a-'o Pf eG'r D)' F • S L , EL. � T l g-b Legal Description: �r I C C-beo g e P LA f Fryyt f RC4uy-yl T-ON Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: or- IP ETAILED DESCRI TI ORK: c- th &n 9 9- v N -5 7-0 Al rangy R rK /o K.W , o e AJ - I L� s ,C.xe- Z Additional work to a—pertormed under this permit-check all that appy: J Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _ Plumbing _Sprinklers _Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �Z S� . Utilities: —Sewer —Septic Building Height: 10 --- Name k7 t) M L e W1 a Name: w U W n Address: p214e GT u r Company: 6-rY 'F- Lo a n TY .4 City: ,,. S �- State: L Address: $��-D AI,W . Lovo y C-61,*Zip Code: T q 8-C Fax: City: r . S , L% State:—E—t- Phone No. 97X 6 97 /q Zip Code: 8'6 Fax: -� E-Mail: Phone No 77 S `70 -3 ? ! O -3^ Fill in fee simple Title Holder on next page( if different E-Mail G%'T'�I and CO(AATY IQ T-Y��M0. ,.Cb from the Owner listed above) State or County License G("+C- 1 7 '73-5- If 73.5- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: 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. 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 commencin rk or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Li ense Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY OF The fo ing instrument was cknowledged before me The for ing instrum t was acknowledged fore me this�day of ��1 20�y this o��day of 20 /Oby Name of person making statement. ame of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identi5atio Type of Identif' ation Produced Q (Sig a of Notary Public-State of Florida (Signature of Notary Public-State of Florida ) Commission No. (Se ) � °= Commission No. (Seal) 0.2 REVIEWS FRONT ZONING R OR PLANS VEGETATION SEA TURTLE M NRE COUNTER REVIEW �lo QVREVIEW REVIEW REVIEW DATE � g RECEIVED o DATE Q it i z COMPLETED �'" i z ev. N � p 1 r ire cto ry.r rg Certificate of Product Ratings AHRI Certified Reference Number:201394391 Date:09-25-2018 Model Status:Active Old AHRI Reference Number:8412933 AHRI Type:RCU-A-CB Outdoor Unit Brand Name:RUUD Outdoor Unit Model Number (Condenser or Single Package):RA1430AJ1 Indoor Unit Model Number(Evaporator and/or Air Handler):RF1 P3024STAN Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS,INC,OK,SC,TN,TX,VA,AK,CO,CT,ID,IL, IA,IN,KS,MA,ME,MI,MN,MO,MT,ND,NE,NH,NJ,NY,OH,OR,PA,RI,SD,UT,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:29400 SEER:14.00 EER(A2)-Single or High Stage(95F) :11.50 t I v. 1 k f"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 F 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 r selling or offering for sale. 1,' Ratings that are accompanied bv WAS indicate an involuntary re-rate. The new Dublished ratina is shown alona with the Drevious(i.e.WAS)ratina. 6 DISCLAIMER g 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, it 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 ff unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the i directory at www.ahridIrectory.org. s 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 r The information for the model cited on this certificate can be verified at www.ahridlrectory.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. —-- 131823787296488987 ©2018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: