HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
.... 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 TYPE:
... .............. ............. ATE. ............. ............. ............ . .............. .............. ............................
Address: .
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: 193 - 1 _bee ...........................................................
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Additional work to be performed under this permit—check all that apply:
mechanical Gas Tan
k Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ ITRO�C/o Utilities: Sewer Septic Building Height:
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%:
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Namellormun -R Mai` 1 Name: Ohrrs
Address:J9 Company: & b
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City: Sf/Oct(f State: Address: � I
Zip Code: Fax: City: State:
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Phone No. _7%w 7V , V Zip Code: L � Fax:
E-Mail: Phone No g�J7-s,3-677E
Fill in fee simple Title Holder on next page(if different E-Mail RXM 10�tv,ArOiI�Yjlrr no-62!!l
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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
commenciQg work or recording our Notice of Commencement.)
Signat a of Owner/L ssee/Contractor as Agent for Owner Sig6t&t of Contractor/License Holder
STATE OF FLORI LTSTATE OF FLORID,&
COUNTY OF a COUNTY OF .0mW41
A
Or
The forgoing instrument was acknowledged before me The for oing instrument was acknowledge before me
this day of - 20� by this day of% 20 by
-� ti �(
Name of person mak7OR
ment. Name of person making statement.
Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
1_1_ )c_ 0 CIL2
(Signature of Notary - (Signature of Notary Public-State f I r'
Notary Public State of Florida State of Florida
�ry public
Commission No. x DebQrab � Commission No. � � �`��. Notes tis
Y COM A n F 234581 Debo �n FF 234581
IVA*o oe� Expires 06/13/2019 � Ml Co��
AA esc'`�:r`:� Expt'eS 06113/2019
iue
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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CERTIFIED
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iTicate o rwr_0 %1;t wm"h to -dam- -Nook,
AHRI Certified Reference Number:201294083 Date:01-16-2019 Model Status:Active
Old AHRI Reference Number:7943535
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AHRI Type:RCU-A-CB {
Outdoor Unit Brand Name:RHEEM
Outdoor Unit Model Number (Condenser or Single Package):RA1648AJ1
Indoor Unit Model Number(Evaporator and/or Air Handler):RH 1 T4821 STAN
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 RHEEM 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: z
Cooling Capacity(A2)-Single or High Stage(95F),btuh:45000
SEER 16.00
EER(A2)-Single or High Stage(9517) :13.00
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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. k
Ratin s that are accom anied bv WAS indicate an involunta re-rate. The new vublished ratina is shown alona with the revious i.e.WAS ratin .
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.ahfldirectory.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; N
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 Nve F1 alk-e life bettel'TM `-
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.
131921197198700768
@2019Air-Conditioning, Heating,and Refrigeration institute CERTIFICATE NO.:
711
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