HomeMy WebLinkAboutBuilding Permitg ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 14/S320 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 Residential ;
PERMIT TYPE:
Address:
Property Tax ID #: '" 4Zb
Site Plan Name:
Project Name:
t-TY) -
Lot No.
Block No.
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:
Cost of Construction: $ 15 461, 44
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Name Name: L)ff-ZC�t
Address: J ii4� r' PeiNAe-b Company: /". d V
City: State: M� Address: N36 "(C'L}S
Zip Code: Fax: City: C{,fA2Le CC&
Phone No. Zip Code: 3 4ck LtS Fax:
E-Mail: F'A (e"1 C M 11NUNILK(DW Phone No T'lZ
Fill in fee simple Title Holder on next page (if different -Mail ::JjLt-Ai,( !(+� I
from the Owner listed above) State or County License CAO
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.
State:
��;�-.
OWN
DESIGNER ENGINEER: Not Applicable / — pp
i �._
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
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
MENCEMENT MUST BE RECORDED AND
TWICE FOR JWROVEMENTS TO YOUR PROPERTY. A NOTICFRN�OTIICE
POSTED TOE JOB SITE)BEFORE THE FIRST INSPECTION. NTEND TO OBTAIN ANCING, CONSULT
WITH Y R L DER O ATTORNEY BEFORE RECORDING Y OF COMMENC NT."
Si atur Cont ctor/Licen oldeST
Sig=ureof ner/ ee ontractor as Agent for Owner
A
COUNTY OF 1 u (' t' F
S OFF ORIDA
COU TY F 1^
The for oing instrument was�acknowledged before me
this day of A O' - (, 20 Qby
The forgoing instrument was4c <nowledged before me
this 'day of 202_Oby
ae ;--e Z
to �—p 7
Name of person making stafement.
Name of person making st ement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identiifi�ation .,
Produced VL � (�?� S�
Type of Identifi ation
Produced �y.� Ve= J= L, C'Carj
/V_Z_6-
(Si ture of Notary
(S ture of Nota
raters Public State a Fbrida
Commission No. Leo M&%eaI)
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CSeorida
Commission No.Y P�� of RoWa
Mara ommist w GG 252204
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEAT R L
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
AHRI Certified Reference Number: 204171378 Date : 04-05-2020 Model Status: Active
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name : RHEEM
Outdoor Unit Model Number (Condenser or Single Package) : RA1460CJ1
Indoor Unit Model Number (Evaporator and/or Air Handler) : RH1T6024STAN
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, 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 RHEEM product is responsible for the rating of this system combination
Rated as follows in accordance with the latest edition of ANSIIAHRI 2101240 with Addenda 1 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-: 58000
SEER : 15.00
EER (A2) - Single or High Stage (95F) : 12.50
?"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.
Ratings that are _accompanied _by WAS indicate an involuntary re -rate. The new published rating is shown alono with the previous (i.e. WAS) ratina.
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. Certified 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, AM
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.shridirectory.org. click on "Verify Certificate" link we make 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.
02020Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 132305968842633044