HomeMy WebLinkAboutBuidling Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number-,
Building Permit Application
Planning and Development Services
Sul/dIng and Code Regulation DIvIsion
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772-1 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
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Legal Descript1 ion: \11 ST14 L!,
Property Tay, 0 #: 3142Z 5L-�o Lot, No.
Project Name.- 75) STO
Setbacks Front--.-,-- Back.- Right Side: Left Side:
ElAILED DESCRfPTIO,'
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N OF WORK0
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CO N' TRUCT10 N, I NFORMAPO N
'Add1tioria""i w&F -e- P rformed unde—r--t-his permit CTeck-41VLa apply:
LNHVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch I I
Total Sq. Ft of Construction:
Cost of Construction: $ C)
S q. Ft f Ho I rj
z t F I'll op r
Utili.,
LIISewer LSeptic .., SBuin ldig Hei
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CONTRACTOR,,
�-OWN� R`,�'LESSEE*
Name 0 70 �S:TZD��/ Name,
Company: AC s% LL
ery Address: e-,
City: ►+C state: �&�)Y Address-U.4.
L4 'State*
Zip Code: Fax: city:
L
--,q Sq
Phone No. Zip Code: 3 Ll 91 ( �
Fax.
WITM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Phone N o
E-Mail: 31,A0, uai�) We"� axRC V, ctp V C_ 0-
State or County License-. chc I
IT vatue OT construction is ZWU or more, a RECORDED Notice of Commencement is required.
DESIGNS
9
C-.11161111EER0 t1ot A
Name:
Address:
City: e
Zip: Phone
FEE SIMPLS TITLE HOLDER. Not Applicable
Name:
Address,
City:
Zip: Phone.
MORTGAGE COMPANY: Not Applicable
Name.11
Address:
city: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name.0
Address:
City:
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 Count v makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or angcovenants 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
WARNINe 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 morkor recordiRgy-our Notice of Commencemq
Signature of Owner/ Lessee/Contractor as Agent for Owner Signatur of Contractor License Ha l er
STATE OF FLORIDA p _f-4-STATE OF FLORIA
COUNTY OF
The forgoing instrument 'vas acknowledged before me
I this dayof Z�'LL� 20 16) by
IV.
'3)(AV 'I d ?) LV*) d-e.Ar
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
7 -*'
,(Signature of Nt�Gry'Publllc- State of Florida
R ZE
Daniel
REVTW FRONT I'10"NING
- I COUNTER REVIEW
DATE
RECEIVED
I..^CO +1P L TED
Rev. 8/2/17
The forgoing Instrument was acknowledged before me
this day of 26 by
law I &
__�_=Wwvwwffl� I
Name of person making statement
Personally Known -- A OR Produced identification
Type of Identification
Produced
(Signature of Notary Pub li6--, State of Florida )
V-7, 1W.W _W_ _W -W W - W - - - I.M6 I'll
Com s Wtory pW*o gtge of FWda alb
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y comminiorl FF 90"196
Michelle Daniel
SUPERVISOR I PLANr r VCGEUTION SEA TURTLE MANGROVE
REVIEW REVIEW I REVIEW REVIEW REVIEW
AHRI Cartiftsd Rewlialrance Number: 201166854 Date: 07-01-2019 Model Status: Active
Old AHRI Reference Number - 7490964
AHM'Type : RCU-A-CB
Ok,itdoor Unit Brand Name: RUUD
Outdoor Unit lMbdei iN\Wmber (Condenser or Single Package): RA1424AJI
Indoor Unit �hlodd Number (Evaporator and/or Air Handler): RI-11T2417STIMINNI
Region Southeast and North (AL, AR, DC, DIE-, FL, GA, Hi, KY, LA, i,,,109 MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, 0, it
lAP KS, MA, ME, Ml, MIN, MO, MIT, ND, NE, !�H, NJ, NIY9 OH, OR, PA, Ri, SD, UT, VT, V06%, WV, 'W, WY, U.S.
Terdtories)
Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligibie 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 manufactrurer of this RUUD product is responsiWe for the rating ofthis system combination.
Rated as fbl1bvys in accordarnice with the latest edition of Ali SLIJ-1,HRI 210/240 iAfith Addenda I and 2, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRl-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High �tage (95F), btuh : 2-4,000
SEER: 115.50
EER (A2) - Single or High Stage k95F) : 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.
Uatigas that are accom anied b WAS indicate an involuntaU re -rate. The new gublished ratinc g is shown aIona with theDrevious (i.e. WAS) rating.
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 aH 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 vafld ony for modeis and configurations listed in the
directory at www.ah rid lrectory.or,.
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; phom
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-ah rid irec-tovy-ora, egick, oni "Verify Certificate" link we make life betteell
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
@)2019AIr-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 132064648215407834