HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i ^ .'��-' Permit Number:
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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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION.-
OCATION:Address:
Address:2:2) ;— i C_,-, % C=�- �- - ` �,"c. _. .4 5'r -)-
Legal Description: t aro C t - •-� l� -c�; '� -^�
PropertyTax ID #:--2',43 > _ / QQQ I Lot No.!
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
' DETAILED DESCRIPTION OF WORK:
i -t
CONSTRUCTION. INFORMATION:
Additional war to be eFrormid under this permit- cneCK all that apply:
L]
HVAC Gas Tank E]Gas Piping _ shutters windows/Doors
Electric Q Plumbing Sprinklers E Generator El Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ .4 "J -,a o Utilities ll Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ✓" Name: = X61-. .E d21_,L t. 0n n -
Address: - C_ Company: ,(_
City: L f f vim = r ' State: Y Address: r - --
Zip Code--��"'- -- Fax: City: State:
r
Phone No. Zip oder q5 -r-S Fax:
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E -Mail: Phone No. �- `f b J�- Z
Fill in fee simple Title Holder on next page ( if different E -Mail:
from the Owner listed above) State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER; _Not Applicable 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
structure. Please consult with pyoiur Hlome Owners Association and rules,
wyyour deed or any restrictions ants that which ay restrict
may apply. 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rnmmpnring woxlc-r recording your Notice of Commencement.
re of Owner/ Lessee/Contractor as Agent tar Uwner
Si atu n Tactor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OFJ 5-1— a! -t--: Cr COUNTY OF °`
The forgoing instrument was acknowledged before me
this i Fday of 20 a ''by
� I
Name of person making statement
Personally KnownOR Produced Identification
Type of Identification
Produced
(Signature of AYL NE
FUe�'i
;o ,Notary Public -5t of Florida
Commission N - .- scion # L���3167
My Commission Expires
January 21, 2023
REVIEWS
FRONT
ZONING
SUP
COUNTER
REVIEW
RE
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ERVISOR
:VIEW
The forgoing instrument was acknowledged before me
this day of 20 20by
Name of person making statement
Personally Known �+ OR Produced Identification
Type of Identification
Produced
(Signature of Nota
Commission No.
PLANS I VEGETATION
REVIEW REVIEW
ft-0TRFU5t1 G A G N E
Notary Public -state of Florid
Commi513iq,S tdbp 293167
My Commission Expires
January 21, 2023
SEATURTLE I MANGROVE
REVIEW REVIEW
ang
Certificate of Product Ratings
AHRI Certified Reference Number: 202098131 Date: 05-17-2020 Model Status: Active
AHRI Type : RCU-A-CB
Outdoor Unit Brand Name: WEATHERKING
Outdoor Unit Model Number (Condenser or Single Package) : WA1436BJ1
Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-21
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, R1, 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 WEATHERKING product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSUAHRI 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 : 34200
SEER : 15.00
EER (A2) - Single or High Stage (95F) : 12.50
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 Par idipant is no longer producing BUT is still
selling or offering for sale_ viousi.e. WAS ratio .
Ratings that are accompanied by WAS indicate an involuntary re rate The new aublished ratio is shown afon with the re
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.ahridireetory.org.
TERMS AND CONDITIONSit NA�
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; copled; disseminated;
esm entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, AIR-CONDITIONING, HEATING,
personal and confidential reference. & REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATION y click on "Verify Certificate" link
The information for the model cited on this certificate can be verified a# www.ahridirector .org, Y 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. CERTIFICATE NO.: 132341859969352380
92020Air-Conditioning, Heating, and Refrigeration institute