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HomeMy WebLinkAboutDOC082019-08202019105224All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: WN WAa� .t. R M� E k . e Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Phone: (772) 462-1553 Fax: (772) 462-1578 Residential PERMIT TYPE: e Address: / f%2- lL'7�- L0 b 5 zar Property Tax ID #: 3 q _ Lot No. _ Site Plan Name: '�v:p I' 'A' Block No. ?� Project Name: yYi iy} r 41s�} }mrril�".t•i\x\n,k i''`;: t),s+ ,,,,� 9 a li'uuM 'Z,JSit,„ \ p \ '4 �.RvB( 4•i5 `,..fyMi>;'p}3�;t}v�1;RN p�}Nl„isVril�jprty�{r�pi 4inll4ye `i,i l�fry".�i�,t ,I {�41�o�ti\1$111 t\M�rks1 itt iit,)5�\}ti}?t,+r;�hG; `.,r ,i,�t ..,.., , ,d a','ev1 , A Z6-3O 1 i 1X241i 31 e fZ5--tAhl 2 S AI? 0 Lse razL ' ( BUJ ea4?Z 1 HL-:' 20128/646 Additional work to be performed under this permit -check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters - _ Windows/Doors _ Electric _ Plumbing _ Sprinklers Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �j ✓ Utilities: —Sewer _Septic Building Height: Name,lama Name: Address: /�`27 4i/rt Ld-)91 V 1 Company:_ City. State: Address: fS/JQ7 A//�&V Y-x�}�p�% City: 02!`t t ia' Stater . Zip Code: 4L Y!� Fax: Phone No. !2a)- Zip Code: 34�!2 ff2 Fax: <9-7 2 -��5� 1 E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail / p( a3 1 4- 40 � AOL .6 24 State or County License — CC) from the Owner listed above) 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. AMtt .. DESIGNER/ENGINEER: _ Name: Not Applicable MORTGAGE COMPANY: _ Name: Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: _ Name: Not Applicable BONDING COMPANY: _Not Name: Applicable 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sign a Owner/ Lessee/Contractor as Agent for Owner Sign ntractor/license Holder STATE OF FLORIDA COUNTY 7- STATE OF FLORIDA OF 5 L C' z COUNTY OF .S T The forgoing instrument was acknowledged before me The forgoing instru nt was acknowledged efore me this i S day of &4u6t 209 by this day of V V51 20j� by �c{E /ilGrr7E,r�P Jz:EE ,/i!Grnr,r�R Name of person making statement. Name of person making statement. Personally Known u/ OR Produced Identification Personally Known ✓OR Produced Identification Type of Identification Type of Identification Produced Produced V l,.Ci/✓,Yv / Y M� V� V W N (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commissi "". SANDRA WAS Commiss �y0'e", SANDRA WAL$Q6 rr� al) _ = to o lodda-Notary Public "` Commission # GG 197984 •`'w s a -Note ubt,c � Commission # GG 197984 y x,•ar+ s n xp r t s 'nnu;�•' tt, 2022 REVIE ERVISOR PLANS 4Apr ANGROVE COUNTER REVIEW EVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. AHRI Certified Reference Number: 201281646 Date : 08-15-2019 Model Status: Active Old AHRI Reference Number: 7941343 AHRI Type: RCU-A-CB Outdoor Unit Brand Name: RHEEM Outdoor Unit Model Number (Condenser or Single Package) : RAI630AJ1 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, MB, MN, MO, MS, MT, NC, NO, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SO, TN, TX, UT, VA, VT, WA, WV, Wl, 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. y'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. Ratio s that are accom anied b WAS indicate an involunta re -rate. The new ublished ratio is shown alon wdh the revious i.e. WAS re6n . DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) 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.ahTidirectory.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, Pam personal and confidential reference. AIR-CONDITVONINO, HEATING,, CERTIFICATE VERIFICATION &REFRMERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridhvCtory.org, click on 'Verify Certricate" link lift• b�rrrer^ 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;; 132103521817476017