HomeMy WebLinkAboutThompson permitAll APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Ll ` Z Permit Number:
J �.
9 R '
Planning and (development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT TYPE:
Building Permit Application
( C O.AAD o)
Commercial Y, Residential
I PROPOSED IMPROVEMENT LOCATION:
Address: J I IZI-- i-ry `' M f f'
Property Tax ID #: ` 0
Site Plan Name: o N
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additio I 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: $
Sq_ Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
ez'f
Address: mSI- RvAQ
Company:
City: State:AM
Zip Code: ! tO ..__ Fax:
Phone No. ` O
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: - V 7
e-
City:
Zip Code:
Phone No 7 `I
State:
Fax:
f
E-Mail
State or County License
If value of construction is 5Z500 or more, a RECUKDW Notice of commencement is requireo_
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name:_
Address:
City: _
Zip:
one
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State:
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Narne:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
riavv1vtK1 LUN I KAL l UR 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, l 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
iAWARNING 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-AIN ATTORNEY BEFORE RECORDING YOUR Nnl7rF nscnmMrrqrFjrivFqT 5t
Signature of -Owner/ Less ee/C o ntralf AAgent for Owner
Signature of Contractor/Lis e older
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
�41'A-%
COUNTY OF _.
The focgoing instrument was acknowledged before me
thisdayof k—
The or oing instrum �n(as acknowledged before me
2o[Jby
this day •�{ 200 by
&�ff.L, t
A�eqAzuz,( ,
Name of person making statement.
Name of person making statement.
Personally Known_ OR Produced Identification
Personally Known OR
Type of Identification
Produced Identification
Type of Identification
Produced
Produced
(Signature of Notary Public-
(Signature o otary Public- State of orida
CHRi5 WO0D6ERRY
j
commissl 919 10
-
Commi io,�;>•. CHRISWOODBERRY-
N`. o Expires October 2, 2023
80fl 385 701g
# GG 91911)2
Fain Insurance
o ems,
2 2023
��FFF�aa,•
flonde6ThruTro Fain insurance 8fl9.385.70
REVIEW RONT ZONING SUPERVISOR
PLANS ANGROVE
CQUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
Certificate of Product Ratinas
AHRI Certified Reference Number: 202865072 Date - 04-23-2020 Model Status : Active
AHRI Type : RCU-A-CB
Outdoor Unit Brand Name: RHEEM
Outdoor Unit Model Number (Condenser or Single Package) : RA1424BJ1
Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-17
Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, 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, SD, UT, 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 ANSVAHRI 210/240 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 : 23400
SEER : 15.00
EER (A2) - Single or High Stage (9517) : 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 far sale.
Ratings that are accompanied by WAS indicate an inyoluntallr re -rate. The new Published rating is shown along with the previous (i.e. WAS) 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 pfoduct(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 MM
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal andconfidential 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,
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.ahridirectory.org, click on "Verify Certificate" link we make Iife 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 132321167787199003
g CERTIFICATE NO.: