HomeMy WebLinkAboutBuilding Permit ApplicationALL 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: (7-1.SS Fax: (772) 462-1578 CommerclWl Residential X
PERMIT APPLICATION FOR: To Select from dropbox, r__%Arj'G-k arrow at the end of fine
Address: A4 Nc\ f C, 3q 9 IZ�
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Legal Descr"ption: r,'S Z-0 T
"300 1
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Property Tax I D
Lot No.
Site Plan Name: Block No.
Project Name: A) V1 04
Setbacks Front— Back: Right Side-, Left Side-,
DE"W LED DE, CRJPTION OF WORK-
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1jJ.&NJHVAC GasTank Gas Piping Shutters Windows/Doors
ON 1 0111
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sc . Ft. of First Floor:
.00
Cost of Construction.- $ Utilities., —JSewer Septic Building Height,
Ntk,/LESSE:E,-CONTRACTOR
Name A;
Name-, (L,,r
Address, I I ,-Q Uz
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Company: AC LLC
Sery
City: State:
Address.�n 2_ +11
Zip Code: 39'c") S',a Fax:
city: (4 state:
Phone No. 0 r�
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Zip Code.- 3q Fax.- 77Q -,q Sq _3S11
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Phone No. Z
fill in fee simple Title Holder on next page if different
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E-Mail: i4o , 0�'cs f
from the Owner listed above)
State or County License: c4c I %i
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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NSuAL
DESIG NER/ENGI NEER,
Not Applicable
MORTGAGE CM OPANY: Not Applicable
Name:
0
Name.
Address:,
Address:
City:
State.*_
City: Mate u
zPhone
zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY, Not Applicable
Name.
Name:
Address.
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Address:
City:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as 'indicated,
11 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.:EUE JOB SITE BEFORE THE FIRST INSPECTION,, IF ETITAN FINANCING, CONSULT
T
WffH "OR LENDER OR AN ORNEY BEFORE RECORDING YO; rRNOTICE d F COMMENCEMENT."
Signature of owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA �pr,i- COUNTY OF�)�. 11.) CA_�
The forgoing instrument was acknowledged before me
this day of. , 20by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signa MUL rmb"
Notary Public State of Florida
c
J Ife ommi la Jennifer riAguiar
'X hA%i mr-339,71Sea
J
Expires 06/29/2023
4 A Oft a OL Ab- AL _AL
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 27/719 '
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of, -A L) 20 1' by
o'v i
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
yAfm pm 'J � .
a)
SAY Notary Public State of Florida
Jennifer I Aguiar
C 7I(Seal)
Expires 05/29/2023
AL ld&.dft&L IAL AML .01 Ah,
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
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�A tA t 4 1.11
AHRI Certified Reference Number: 201663836 Date: 08-16-2019 Model Status : Production Stopped
Old AHRI Reference Number: 8224074
AHRI Type: HRCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RP1518BJ1
Indoor Unit Model Number �Evaporator and/or Air Handler): RH I 2417STAN
The manufacturer of this RUUD product is responsible for the rating ofibissystem combination,
Rated as follows in accordance with the latest edition of ANSi/AHRI 210/240 vvRh Addenda I 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 : 13500VVi-1,S
SEER: 16.00
EER (A2) - Single or High Stage (95F): 13.00
Heating CapacKy (H12) - Single or High Stage (47F): 15500
HSPF (Region lV): 9.00
t"Active" Model Status are those that an AHR[I 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 that are accompanied by WAS indicate an involuntary re -rate. The new published r is shown along with the previous (i.e. WAS) ratina.
,atina- -
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 disclairrm all flability for damages of any kind arising out of the use or performance of the product(s), or tine
unauthorized alteration of data listed on this Certificate. Certified ratings are vafld only for models and configurations listed in the
directory at www.ahrld I rectory.,
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHR11. Thiis Certificate shall only be used for lndiAduaG, personal and
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; dissernnatedj;
entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the lusev's hn6vidua1,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this cortificate can be verified at rpflok on "Voflfy 'Got-tificate." 6�nh I'Ve. make 11fe better -
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. 132104352608817746
@)2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: