HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
I
Date.
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential —
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
8
7 7=7
N
c)o-ea-fn Lc,.
Address:
o, n:h
0>
rp
Legal Description: OCQC�o.(�, ac')(ufLI �I-4-11�,
Property Tax ID #: 0 115Lot No.,
Site Plan Name: Block No.
Project Name:
Setbacks Front pu 29-7e i C R�ght Side,, Left Side-,
ve,
N cu+ S*"
i-Io_na_lw_d_r_kt_obe- r0r eun er R Iit ap pVO,,
Nil
I&JHVAC as Tan Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sc. Ft. of First Floor:
Cost of Construction: $ Utilities: Sewer 1 -Septic Building Height:,
'S
7:. ..gip '`'� 7
CQ
NT
Name Name. itch
..... ...
t
Address: 6 Company: KClw
City"
I 0&e,. n tate'. Address: 532- Qj, C-
Zip Code: 3 q'Is Fax:-. City:. Lot- j_u. ::x�m-�iv�.
...-.>w_...,.,..m.,,.,.:��� �.m� State{j1b} o
c'
Phone No. G I I Zip Code: 3q Fax,."7"?QA 3,11 -375-, lh�,
E-Maik Phone No. 21
# --e A,
Fill in fee simple Title Holder on next page if different -flail" ;40 Weeiv 0,c�scr Y j'C
from the Owner listed above) State or County Ucense;
if value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
ENTAL, Ntlt AW,
• :1C , 0)" 10140
,VPPL R. 0. N
DESIGNER/ENGINEER: Not ApplicW'e MORTGAGE COMPANY: Not
Name:
Address:
City :
zip:
State
Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
Citv:
Zip, Phone:
Name:
Address:
coltv.,
Zip: Phone:,
State:
BONDING COMPANY: N o t A p p H c asi b,,.' e
Name:
Address.
City:
Zip: vac cos > 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 awith�your alicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult 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 00akE JOB SITE BEFORE THE FIRST INSPECTIONs IF INTE D TO OBTAIN FINANCINGr CONSULT
0 060' t
WITH WOR LENDER OR AN ATTORNEY BEFORE RECORDING YOJR NOTICE OF COMMENCEMENTa"
Signature of Otvner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA C
COUNTY OF F04-4, J 1�1
U
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20_.)by this day of curcs 20 by
JD ckv i
Name of person making statement. Name of person making statement.
Personally Known.--.6.-,— OR Produced Identification
Type of Identification
Produced
�i��Mkc�� x
.&L VOL
(Signa Awtn
&V A,10 Notary Public State of Florida
R Jennifer I Aguiar 1.4
Commi 1 MY COMMiralWA GG 3398745ea
Expires 05/29/2023
0%
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.277719
x'e'
Personally Known ty'14 OR Produced Identification
Type of Identification
Produced —
a
L
TUMITIDTOM'' a
Notary Public State of Florida
all
Jennifer I Agui.,
$71 (Seal)
'7 y Com i
IPOO Expires 05/29/2023
SUPERVISOR I PLANS I VEGETATION SEA TURTLE ih0ANGROVE-7-
REVIEW REVIEW REVIEW REVIEW REV�EW
AHRI Certified Reference Number: 201176300 Date: 03-04-2020 Model Status: Active
Old AHRI Reference Number: 7493646
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package): RA1436AJI
Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-21
Region Southeast and North (AL, AR, DC, DE, FL, GA, H11, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL,
IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SID, UT, VT, WA, WV, Wl, VVY, 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 : 36000
SEER: 15.50
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 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.
Ratin2s that are accomRanjed bv WAS indicate an involuntary re -rate. The new published rati 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 R-aiblfity for damages ol.j 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,,mtodels and configuratiom.; listed in the
directory at www.ah rid! rectory,,,,',
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRL This Certificate shall only be used for individual, personal and
confidential reference purposes. The contents of this Certificate mnay not, in tivhole or ir) part, be reproduced; copied; disseminated;
entered into a computer database; or otherwise utilized, in aiauy fornn, or manner or by any means, except for the user's indMduM,
personal and confidential reference. AIR-CONDITIONING, HEATING,
R
CERTIFICATE VERIFICATION REFRIGERATION INSTITUTE
The information for the model cited on this certific*kto can bo v9rifigo It
click on I'Verl f y C e U P i n k we rnake life bettern'
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. —32,2-7 8__1,_84__6_1_4_9_54__2__68_
@202OAir-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: