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HomeMy WebLinkAboutSLC PERMIT BERGOINEAll 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 Residential4
PERMIT TYPE: mt vi a-n c a —
PROPOSED IMPROVEMENT LOCATION -
Add ress- co7o II I CLk), V (�
Property Tax ID #T I a ' �i ©' �Qp� 7� Lot No.
Site Plan Name: r Q f L T. _ �a d 'J r0'(Block No. l I
Project Name:
it 14
[DETAILED DESCRIPTION OF WORK:
i z i I ti i L� ` c'o A J'I
1`. v n -r" r I', v o t. i-►n mr, , • 0'F f'V1 : I [ /J H Ir&G I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank ^ Gas Piping Shutters
Electric — Plumbing
Total Sq. Ft of Construction:
ce>
Cost of Construction: $' C
Sprinklers — Generator
Sq, Ft. of First Floor:
Utilities: Sewer _ Septic
(OWNER/LESSEE:
CONTRACTOR:
Name * ' i "I
r C, I , ��
Name:. i �$�lrl
G
Company: i � fi 1-
Address: Q w1 11 p J
City: (-f- 1 Stater
Address:
Zip Code: � Fax:, n I a _
City:stla (
qH I
Zip Code: L4
Phone No.
E-Mail: In I a
Phone No�
E-Mail r, LO
Fill in fee simple Title Holder on next page ( if different
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.
Windows/Doors
Roof Pitch
Building Height:
C If I
A� r (o cl - _
State: R_
Fax:
c nr:.r rs.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and instauation as inoicaiea.
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
structure. Please consult with pyoiur Hlome Owners Association Association
andrreviewyyour deed for any restrictions wh which restrict
may ap. prohibit such
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."
ig ure of Owne essee/Contractor as Agent for Owner Sig re of Contractor
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF i1 _ COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this{ day of 20f by this% 2 day of 2Q by
n Wt�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification ,
• ; -a - -
Commissi .
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a S�larina�i
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REVIEWS
FRONT
ZONING
COUNTER
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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5 PERVISEGETATIATURTANGRO
REVIEWOR 1 REV EW I PNSVREVIEWON 15EREV EWLE I ..RE EWVE
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Certificate of Product Ratings
AHRI Certified Reference Number : 201285995 Date : 02-06-2020 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 Handler) : RH1T3617STAN
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, It 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 AHRI 210/240 with Addendum 1, 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
t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering far 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.
fin that are accom ied b W 5 indic to an involuntary re -rate. The new published ratinq is shown alanci wild the provious i.e. AS 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 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. Certltled ratings are valid only for models and configurations listed In the
directory at www.ahridirectory.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, AIR-CONDITI(INING, HEATING,
personal and confidential reference. & REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate' link we matte life 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. 132ZS4851356709123
c0202OAir-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: