HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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: To Select from dropbox, click arrow at the end of line
PROPOStDtM�PROV�eMENTtOCATION*
Adclress:.�i',
Legal Description: CKo 34 3 "t _14)1: PAS X(. 4�s '5 _OLUI-2,3,30 - 19,3 is c -r
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Property Tax ID #:6 ��' t._ _�' fI - ���a Lot No.
Project Name.- _
Setbacks Front
g1=101
Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION,
rtorme s permit__check all appy,ifional work t i d under thia
�NHVAC Gas Tank Gas Piping In Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 00
S. Ft. of First Floor:
Utilities: n Sewer Septic
Building Height:
OWN E'R/LESSEEP
CONTRACTOR,
Name 7S_041
Name:
Address: 11 Liq Iq
_V ..
Company:
City: 7�p-+ State:
Address: 5 -3 2— L
a
Zip Code: Fax:
City: _Poro Iu& State: �L
Phone N o,
I- 77Q 3!S I I
3q ol g A..`
Zip Code: �2 - Fay:
No. 1'� 2- -- % -7 1
Fill in fee simple Title Holder on next page if different
E -Mail-, (40 Can
from the Owner listed above)
State or County License: chc I %i ""16 a-3
11 Vdiue ut wnbiruEmun15,?4:)UU yr mare, a Kt%.UK1Jt1J iwuceWtommencement is required.
M EN TAL CONSTRUCTION. LI EN LAW IN FORMATION
nimir..mg:r) iNEER• _
Not /AppllcdlJle
Name:
Address:__
City: State-,
zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:—
Address.0
—
City.� �.�
:-�
Zip: — Phone:
MORTGAGE COMPANY: Nolt Appflcabkla�
Name:
Address.-
cityo., State:
Zip: Phone. -
BONDING COMPANY: --Not Applicable
Name:
Address:
City* � _ ��_� - __ _�� _� ___.
Phone.-
UVVIMtK/ LUN I KALI UK AI-1-11UVIT: 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 Associationrules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and reviw eyour 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
comrnencingNpr� or recording -your Notice of Commencemert'.-'---,.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Or+ c ,e,
The forgoing instrument was a knowledged before me
this -31. day of 00 to L- 20) by
I.Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
,(Signature of btary Public- State of Florida
Qal)
Michg-41a Daniel
11,�F 906496
Signatur4'`of Contractor/License Holder
STATE OF FLORIDA
COU
NTY
t. 0 OF 'J � :baa
The forgoing instruTnt was acknowledged before me
_C
this ? day of
-P 20 IS by
d,
Name of person making statement
Personally Known_ X, , OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub I+c'05`state of Florida
W W -,w W 9 W W W - - - - - -W
Comm No wo#Fwwa al)
oMichelle Daniel
Nf, I My Commission FF 906496
REVTMl"RONT "ZONING SUPERVISOR PLAN7`7EUE-FT --
ION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
I COMPLETED
Rev. 8/2/17
AHRI Certified Reference Number: 201630757 Date: 10-31-2018 Model Status : Active
Old AHRI Reference Number: 7512115
AHRI Type: HRCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RP1536AJ1
Indoor Unit Model Number (Evaporator and/or Air Handler): RH1T3617STAN
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 : 35600
SEER: 15.00
EER (A2) - Single or High Stage (95F): 12.50
Heating Capacity (H12) - Single or High Stage (47F): 33800
HSPF (Region IV): 9.00
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.
Ratings s that are Al2_C112_P_1PA9�1
WiMIA&
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.ah rid I rectory.op-g.
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,ahridirectory.org, click on "Verify Certificate" link see .make fife betterm
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. F-
1
@2018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 131854858162565267