HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
M-
planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (77 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
14 fou'10 rns.
Address:
Legal Description:
36 q q — 1/0 sc)
Property Tax ID #: CT"--?S�" —001:101 Lot No.
Block No.
Project Name.-, +4u e'>i-9017
S-,
Setbacks Front Back: Right Side. Left ide
DETAILED DESCRIPTION -OF WORK:
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X-fr
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..CONSTRUCTION INFORMATION.:
Additional work to be ip) Wormed under this permit - check all that a-P-PFY.—
Forl
I&JHVAC Gas Tank Gas Piping Shutters Li Windows/Doors
0 Electric Plumbing Sprinklers Generator E]Roof I I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction.- $
'Y
S - Ft. of First Floor:
Utilities: Serer Sewer _Septic
Building Height:
OWNER/LESSEE-0
CONTRACTOR.
N a 140M 0, k
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Name: k
Address:
Company: Ac '�Ier
City: state:"-
Addre .5 '2- Q t-em+* P L tl
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Z i pCity:
ov4 Iu C L-e, State:
P h o n e N o. �ZI -L''q
77a �q -,�!S I I
Zip Code: 3q 9 Fax:
E-mail:
Phone No. '7-7 2-, 11 18�r>W
Fill in fee simple Title Holder on next page if different
E-Mail-, �,401 cy
from the, Owner listed above)
State or"County License: CK I %V1 (a a3
IT name OT consErucTion is : ►►zbuu or more, a 11MUKOW Notice of Commencement is required.
M-,ENTAL,CONSTR�t.,,,ICTION'LIEN 1AW
77
DESIGNERANGINEER:
Name:
NNot Appfl'icable
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C1108rY/11PAA1K0Vr1
Nam�.
Not AppkaWe
Address:
Address:
City:
State:
city.o
Zip: hone
Zip: Pho,,nte,.,
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING
—Not ApplaUe
Name:
N a m e
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 Countv 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 wall or recordinig yo _r Notice of Commencemepf.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Pot-+�# � � ��
The forgoing instrument was acknowledged before irne
0
J�
2 ,,, v v
this day of ti'v" b
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
,(Signature of I`e6`iary_PubIic- State of Florida
P-3
1 410 Da *niel IF 90,"96
REVMW57 qW - PRJONT I' ZON 1 N G
I COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signatur4/of Contractor/License Holder
STATE OF FLORIDA er, o . ......
COUNTY OF
The forgoing instrument was acknowledged before me
thisday of " 9AJ 20 111' by
-haw
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub State of Florida )
Com
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Motal y T_ %~"W
Michelle Daniel
My CommissionFF 906496
--GPTATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW
i 4111� t IL1 I a r 4.11L
AHRI Certified Reference Number: 201285995 Date: 05-31-2019 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): RA1636AJ1
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
fActive" 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.
gRaaltiWg�saithpgatLaaEre%aMcc2ga "a�ieq v WAS indicate an The neXRy
indicate �lished ralMi is shown along with the previous (i.e. WAS) rating.
M WAS) --
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.ahHd1vecto9ry.,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 for the model cited on this certificate can be verified at wwwaVgridirectcpry.org, click on "Verify Cortiff °tc" link we make lif`e betteem
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.
132038020152670903
@2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: