HomeMy WebLinkAboutBuilding Permit ApplicationALL 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 _ X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: � 0 V3 1 Lk's I
Legal Description: SV LU C'' e (_k aS )_G 3.0 '+O 91k Z JVi TI4 i �F W
L� I fIND 1-1 �iWY S C P—LAN SELY hC, L I S I F r. "T 1 0 ►3. ri t
Property Tax ID #: 3 14 J 501 I S66 Cj Lot No.
Site Plan Name:
Project Name: t\4 �, 1`, l(W2 " N 05 S W I
Block No. 2
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
kei(lCc 3.5 +,C)n pfnCK(4y un`J Ovi LrtC k� 1;ke
j� Sec ) 10 Kw ke6Rr.
CONSTRUCTION INFORMATION: ill
onai worK to n rrormea unaer tnis permit — cl
HVAC Gas Tank Das Piping
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
—T'n�: ��—I""
Cost of Construction: $ �--7 . o0
apply:
_ Shutters Windows/Doors
ElGenerator Roof
S Ft. of First Floor: _
Utilities:OSewer OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name G ,uk FL &3-� LM5� �G%14ULL
Name: Ihe_linis
Address: L5 y 1,.114, v1~,(-t �r .
Corn pa ny: ftL6/-d IA6U fnr -(-D/j ►/LSr. +)
Address: �JC) 5! �n1�+�kv►.,�,/
City: PS L— State: L
Zip Code: Fax:
Phone No. $1-I - I (P U
_
City: By DOK �l rr1 State. -Jo
Zip Code: 1 123� Fax:
PhoneNo._CIA_ 131 -2k,6DU
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Ffl-C,,We rA C C X vyt
State or County License: GI L
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION. LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip; Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Zip: Phone_
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 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
commencing work or recordjn%vour Notice of Commencement.
Signature of Owner/ Lesoe/Agent
s
Signature of Contractor/License Holder
STATE0
OF STATE OF FLORIDA
FLORIDA L [ e COUNTY OF
COUNTY S �, Lq <�
The forgging instru ent was acknowledged before me
this Ming
of L4 20 %,�by
C rd
(name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced identification
Type of Identification Produced
Commission No.E-)GAci VDcl
W11u[ir»
The for ? g instru nt as acknowledged before me
this ay of =� �/ 20 2-0 by
nh,�s K-tAzr>I.r -z-
(Name of person acknowledging )
)�— �, 0 (1—
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced t{141l1lbjl
Commission No. Co GN 33 D9
Revised 07/15/2014 `SP 2° " p s309
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I INITIALS
Certificate of Product Ratinas
AHRI Certified Reference Number: 201176177 Date : 07-31-2020 Model Status: Active
Old AHRI Reference Number: 7493510
AHRI Type : SPY -A (Year -Round Single -Package Air -Conditioner, Air -Cooled)
Outdoor Unit Brand Name: RUUD
Outdoor Unit Model Number (Condenser or Single Package) : RAW 4042AJT***AA
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 RUUD product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 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 : 39000
SEER : 14.00
FER (A2) - Single or High Stage (95F) : 11.00
t"Active" Mode! 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.
Ratinqs that are accompanied by WAS indicate an involuntary re -rate. The new published ratina is shown alone with the previous fi-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 products) 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, MM
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.ah rid! rectory-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 CERTIFICATE NO.: 132406950467339118