HomeMy WebLinkAboutBuilding PermitP anning and Development Services
Building and Code Regulation Division
2,300 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
Address: "Y
Legal Description:. LM,"-,CW00
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Property Tax ID Lot No.
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#:
Block No.
Project Name:
Setbacks Front Back: Right Side.- Left Side-,
DETAILED DESCRIPTION OF WORK:
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Additional work to be Pertormed under this permit — check all tiat apply:
OHVAC Gas Tank Gas Piping In Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pi-tch
Total Sq. Ft of Construction:
Cost of Construction: Q'
Sc,. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CGNTRACTOR.
Name
Name.i ur
Address: i -ell no"l,cA
Company
city: State:
Address:
�5101 Fax:
Zip Code: '3q q i
City: Po,64 �4,. )_U C State:`
Phone No.
Zip Code: Fax:
E -Mail:
iemeru
Phone No.
Fill in fee simple Title Holder on next page if different
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from the Owner listed above)
State or County License: . C'. AC, 1 6 a3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r 71 7-N il MAI INFORMATION
U r ?Lt W11 N A L R U C �m U
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:Name:
Address:
Address-,
City:
SS 1: a t e 4*1
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
commencing w
&Aor recording your Notice of Commencerne
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 1_1 day of 20 /8 by
low *1 a t-) t Y)
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
f xno
JSIgnature of Peotary Public- State of Florida
P -M
Daniel
w" FF 9,00496
-FRONT ZONING
COUNTER I' REVIEW
DA—i E
RECEIVED
DATE
COMPLETED
Rev. 812-A-7
Signaturto/of Contractor/License Holder
STATE OFFLORIDA
COUNTY of
ir
The forgohig instrument was acknowledged before me
this day of lkw by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary PubN6 State of Florida
-r w -r w -w -1w w Comm S10
Michaft Dan*-'
My Commission FF 906496
SUPERVISOR I PLANS-- Vl�_GPTATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
AHRI Certified Reference Number: 201294100 Date: 11-13-2018 Model Status: Active
Old AHRI Reference Number: 7943537
AHRI Type: RCU-A-C(,-"B
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RA1648AJ I
Indoor Unit Model Number (Evaporator and/or Air Handler): RC 1j V4821 STAN
Region All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, r,(, LA, MA, MD, ME, MI, MN, MO, MS,
MT, INC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, \/T, WA, WV, Wl, WY, U.S.
Territories)
Region Note: Central aur 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/AHR1 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 oriigh Stage (95F), btuh : 44500
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.
datinas that are accomoani ed bv WAS indicate an involuntary re -rate. The new ublis ed ratinq is shown aloe a with the revious (i.e. WAS) rating.
m
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. AHM 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. Cevtified 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 AML This Certificate shall only ire used for individual, personal and
confidential reference purposes. The contents of this Certificate may not, in vihole or in pawl", �e reproduced, coped, disserninated;
entered into a computer database; or otherwise utilized, in any form or manner or by any nneans, except for the user's individuall,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited sin this certificate can be verified at wtt�wah rid 1reatory.org, click on "Verify Certif lantk,-o" link arc make life bcttt:r7,'
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, and Refrigeration Institute I CERTIFICATE NO.: 131865936986961453