HomeMy WebLinkAboutScanned from a Xerox Multifunction PrinterAil APPEICABLE II9FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Iga,,,lSe, :
•
r r
6uhaing Permit Application
r•lanning anu ueveropmenr cervices
vuhUing arta Cc Uu tfcgw-r.v.. LJ.T.�.v..
2 -IOU v;, y.,,.0 ase„Qe, tort Pierce FL 34982 J
Phone: (772) 462-1553 Fax: (772) 462-1578 l..amrMer%i-al Kc�Igential G�
PERMIT TYPE: NFC 1 �01,GLiXICCC,(L
PROPOSED IMPROVEMENT LOCATION:
Address: (�I i 15"act kd Of* ?k& -k C(5, F [
Property Tax ID #:3`'103- I o- j- UoLn - QO L)--%--LOL No. 4- Q0+z
Si►e Plan Name: CCS(_ 61ocK MO. l�
Project Mame: V-Uac� svv—,uvr-1
DETAILED DE5CRIPTION OF WORK:
r-xact HI✓ ctlangeout, no tlucl worR, L son, i ij seer, It> Rvv
CONSTRUCTION INFORMATION:
rtdditional work to Be perrormetl unser tRis permit - cRecR all tR-.t apply:
XIDlechanical _ Gas Tank _ Gas Pipins — Shutters _ Windows/Doors
_ Electric ^ Plumbing — Sprinklers
i otal -)q. Ft OT CoR,TFUCT 19:
Cost of Construction: $ �J ruction:
r3enerator T Roor PitcR
SH. Ft. of First Floor:
Odlities: _sewer _ zeptir- 6aildiR6 Flaignt:
OWNER/LE5SEE:
CONTRACTOR:
IQam� Q� S ra
Name: Dennis Zacek
Address:
Company:HKS
City: Piet L.E State: 1A
Address:2800 US HWY 1
City: vero aeaon State: FI
4ip Code: C-. Fax:
Phone No.-�jtrj • ZG 1 • C)RSD
Zip Code: 32960 Fax:
Phone No (772) 794-7205
E -Mail:
E-Mlail mgillis�wars.com
Fell in fee simple Tile Holder on next page ( if different
from iffle Owner liatcti above?
State or County License CMC1249753
it vague of construction is 5zaou or more, a r%ELvnDED Notice o, Commencement is requires.
If vaoue of nvHC is $1,50 or more, a RECORDED Notice of Com cmC.McNT is r.-e;yre.
SUPPLEMENTAL CONSTRUL i 10 LIEN Dew IwFuRMIHI IUM
DESIGNER/ ENGINEER: , Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Dame:
Addre»:
Andress:
City: zotaie:
City: State:
Lip: Phone
_ _
Zip: Phone:
FEE 3IMP[E i i i [E HOLDER: _ Nut Applicable
BONDING COMPANY: _NOL Applicable
Na, ,,e:
Dame:
Addrez,b:
Address:
City:
City:_
Lip: Phone:
_
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: ,Application is heredy made to osrain a permit to do tpc -orR .Ra in,tzilation as indicated.
I crtity tFiat no work or installation has commenced prior to the issuance or a perm t.
at. Eucie Count- rri..Rc, mo rcpr,,c..tation tRat is granting a permit will authorize the permit holder to build the sudject structure
wllicR is in conAict witn any applle.we Flo—c U .nGr, A;3a�,.tion rules, bylaws or and covenants that may restrict or Nrohioit sucR
structure. Please consult with your Rome Owners Association moria yoe, dced Tor any restrictions which may apply.
In consideration or Arte granting of tRis requested vrrnit, I ao Re,cSy .gr�c that I will, in all respects, perform the work
i.. at-cor3an..e—.itR the approved plans, the Florida Building Codes and ,)t. Eucie County Amendments.
, he following building permit applications are exe.:pt Trvri7 eRaci:6oin6 a tall voncurrency review: room additions,
accessory structures, swimming pools, rences, walls, signs, screen roorm3 aria ;-.eet-3,ory 03c3 t., anotRer non-residential use
vvARim-MG 10 OwIaER: Your failure to Record a Notice of Commencemem may result in paying twice ror
improvements to your property. A Rlotice of Comment-lumu=,t must be recordEd in the public records of St.
Lucie County and punted on the jobsite before the first inspection. If you intend tv obtain financing, con3talt
,,,,ith lender o, an attorney before caTrrrilencing work or recording your Notice of Cz;mrne;,cernent.
O�a�
_ _ 12i�ni�J�
qw-�
�isri-ter= of O.,.ncq Cense ontractor as Agent for Owner Signature o Contractor/Eic se molaer
STATE OF FLORIDA
COUNTY OF -r-,;-
STATE OF FLORIDA
COG I T OFs:L-m
Sworn to (or affirmed) and subscribed before me o, ,)worn to (or afrirmee) one 3-a6,.rXra Beterc me of
x Phy,icol Presence or Online Notarization Physical Presence or Online notari«t:on
tRis day or 2020 by this day of ___ Z'UL'U sy
Dc. ,.:z Za,cn V.nnis Za R
Name of person making statement. Mame or person malting statement.
PC,;onwlly Rno7v" x OR Produced Identification
r ype or la I'aicotion
Produced \,3i -,v,-vr., L,Cekz-#--
jbigm .terc at notary NCI
Commission Mo. v33.a;:5
maid of Florid.. - Rola., P,
Cgtii fission # GG 3401
My Co. mia-:on Epi _s May;
REVIEWS FRONTI ZONING
COON I ER REVIEW
DKIE
RECEIVED
DATE
COMPLETED
Personally Known x OR produced Iuentidcation
I ype of Identification _
Prvaezea dCt�a�CS Uc���
]Fizoiatare oflgotary PuBli,- St rir� 1
MELISSA CHATEAUNEUF
fission Ido.v5,o 7 State or l?,or9aa - riora., Pu61td Cornmirmion 9 GG 340178
SUPERVISOR I PLAN,) I vEtt31iAIIOM SEH rORI[E IvANt RO
REVIEW REVIEW REVIEW I REvIliry REvIEvv
I -star anion W rk Oruer
• iV:07-3101. C,1.:"'�-fl �,cvlx
.1' 1
. . 4 v e` rr Fl, it L
1Ra=n�i"nv'; Sa, n'.l C,TM}` _iP164Ly1 F,YTfl .1 Irl !_ti"r^7%.,-Cb'.�tu•
13,
•mC�74 - a I11
—Yv[rFae�xu.n
y -v
TYPE
Fri1L:lE4.�. t.y ..
° lFR:.1.Kr.y
ju
.-!TmYj
57-1 — "--
ISI.aroiI1FI.lT.4ly '.
I'pr +r4l:I.R,±L �.. �- I•anlr!}•L-ryl., :;
FF
—
�� H.,xl i .IIJ Q.. _ l •IYI? �d.nr tiln.• I
..i,•F.,,V1M'A_..,V�._.'. VrvF rr..rl'��,Iw14 .RY.LI.• _, _. �. -. _ Wi'I•r
r. 4
,T 1 •:. cc.. wl•1 DF.w rlxr,F V�u •11 :,,.• 13 Udn.u.i�� --
°T — SU BrOTA4 S •1.� t.;� !
rl � �S:ulrp.,.µc Ki: �7 c*�sLIY+•I,rI[-LJ 1
6 cIM1•o.l:c cum= ••t :aui: Tr...l.cdi� Q hr -r 1
QSver,J lw.twl•:r, ..q, y I
1ji lh�� Sur,.; S+.q�! $ d//■��yy�.Irrcrl c:erncc lll,I ra _ . 1
!J_�''II11r �Irr r:a•41i l'• F w;.r pain•,•.: al,y LJ•rJ'I FI:I I.1.•iYlr� 1
;• rQ}'1 /��i�Elil.l`:Inrnl [�j 11L Aj JI;iILMll:nl{ 1
rR{i�r 1Q. . I.rIC/ll Pk;.rn
1 Lyp�l,,,l Ix ��''''�rr f9'�Ilrn.,,1lr� ��*J�! ::r.rr.y rlr•n I 4 -'•�' �
—}�aR �1•wr:rneC 1GrRasn•�a+a. I
PprrL7iFk.ISI:�.IrF,
°T'�p:}r:.n"'Sj7c COc�" CI•yb'K tlCarl�[C: CY f+N= ,Q(;A}Fk f]rI II:C1
x-rr unt,- C13,m M R'r.r[f1eQn E� t'.17.'RRC.:1 Ti, rrg
0rcfrrlra}{1j�1 rjll.^.Irn.:Sq•.r1�;;;Flx, Q!%KFui-CARD :LAS740 : ?
Hyl : �uln rn fi A.INTO CI Fid _ . 1 'v-:1;334 d.;_j V1 ,_,,..APP OL'nr
�UYll�rsl ,
esrP�aovd,�aL I7FlcrYvi�c• '�FIrJr•NCl•1C,�
u.l.ar+.l.r:;•n.nS. r.c,, s�1a,,. W1�,•*1
.. ..
I+y+, wt rav ,-p■,-qR
rl CotlforC,uuar:ae LI l{71r-Prolwoli_e C■ -:■4r: TF1%••. •..n�IraR{r •rr -r In ...
!•'� 11%_nT!$Sillit •til
�Jiv�Gr.a�.lrl4CCW:II.S'110Y E71e's;.�yleulrJoarlk�lr+.+••Li.�jcCci:f-:I_s ,.....:alt;v,l•..s,•-e,.. ,,,.f,:I,J-,Ti.. ,
is. --msprtiLiv-wprmss'.ukLkv urs Ttf,,4iFim1a.r.AliormvurdmMRu.1Lmr.ma . dele�_
IFR :.:t:.■le• aslhcaeferl..N a e aWiWd �,Iba! brIvR =sy mr, e11Uween e0l. aa., el elle mc -z r..:1.
QANSFOR C04STFiUCTIONDF-cLI&AIIE4t1H1kCfIOTHE"C"EAHDCUSE-R00t$AGNS`O'CNAJ-IEt5lE F'CR@ASI14.1.EEE&
f EWS RICHme T TO CANCEL: Thi■ b : holdliMm onto: , nd if Van da netllRnM thy goods or lotw.os,ywr may weeel this soma
5j,mW1ns TrdUn metice to Eheslrllerin peleerl, Py tefaRlnel, why mail. This Mien FRIM Indla ftlhatToa do nor wantaom goods
la Ices and muse ba dellvaW or postmarked balm o m1unipla or Mir �,lyd tipsiness any attar you sign illis p pn,,L tf )mo eencel
pl.�..—ef,fhe_effermrrI tkvqP-IIerrod of_nywon dwrn.paYF�■nt,Sealhemael,o.Fda'her■uTloran onpl mtlonofthlo.lsht.
km bdr ll- E try (bil la comas' lravmm capbir.t is mao-a1, emd P vt I,nF, e11d �Rhi tl'Ir�rr. �w,-If r—n• Ill,. ;nh�d¢e d e pksF,m ante al
tk �fv.IO IM M1!rnn rn(l C[M7db6Ra Sac'1Q ih rn 1p-mrr,. v:lds bri-aul, otic el10le5SFiDiw.PCi7n. r
M To Omer • Do ►I.t sipq tJ11s home fmploMa1411rE oem1m IN k. Yom aro mUbd to ICU" *f#ml:mn4,e at 09 ulna yon mom �
k Zo yolFrkgal llOhts 1111s bane lalpmvement oortkra Conlr4l a tamflg or otherwi- W-116 o Ilan vn yo -6r ptopw.
foreduse5AR 11 yoe donor ply. Bee yorl P cilinala0
1.tr1 or od beroroyou olom
earl n F 1-- IN
:;
r{rsFq-u4r
top
�I,.w,, II°I(I,R,I;r€e,L„]t.lr_ +�l�V]•ylle...eS r.r_ler.�.. �,>v_. er�x. ■alI
mmal CERTIFIED'
o
Certificate of Product Ratings
nARI Cerlide'u Reverence Mulnber : zb2865urn Date : 013-Zl-0ZO Maaol States: Active
AFlRi I,p.: RCQ-A-CB (Split S,etom: Air-Cool.d CaAensing Unit, Coil with Blower)
Outdoor Unit Brand Mame: RREEM
Outdoor unit @lodel Number (Condenser er 5inylo P,-eka7o) : RAI4z4BJ1
Irlaoor Dnit Maael NamBor (E.aporatar andlor Air Hanaler) : RH1 P2417STAN
Region: Southeast anZi Mortll Zr,E, mR, Gam, CE, PE, un, Mi. R T , CA. ICI., Ms, MC, 01KC 5C, I M, I A, VA, AR, CC, C I , tD, IL,
IA, IN, Rs, MA, ME, MI, MM. MO, 1911, NQ, NE, NR, NJ, NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, YYI, vv 1. u.o.
r erritoriesl
Region Mote: central air con'aitioners manuvactured prior to aanuary i, zU i* are eligible to 6. inutallea :n ulI reyiemu
until Jane 3[], 2016, Beginning July 1, 2016 central air conditioners can only be installeu In regionZsf vor
which they meet the regional eniciency requirement.
he manufacturer of uvis RHEEM product is responsible for tae rating, eT thio oT�lorR eem6inatio...
Rated as follows in accor'uance with the -latest e'uition or AIV5VAMR1 z rvwz4'u with Adden6a I and z, PelTopmarloe R,.tiRy vt Q..Itwr,
AIS-CerlditivltiRy Sc AIr-tiez;ree Float Pamp Eynipmont and -oabjuct to rating accuracy by AHRI-sponsored, lnuepenuent, thiru paR9 iesLiny:
Cooling Capacity (A2) - Single or High otage (551F1, btuR : zz350
5rl_R : o+-ZO
EER (Az) - Sirlyla ar H;gn Stye (95F) : 11.50
IOlwal o;atas are those that an AHRI Certification Program Participant is currently producing AND selling o: �fferina fur axle; OR no. Modula that ..re beAg
Marketed bet we .,.t y.l b.i„g prodecaa.?Proua0o.. Stuppea , Moo.l Maces are 1Rose that an AHRI Certification Program Participant is no longer producing BUT is st:il
�sIIIRn er affe- fer oala.
rd'i1n s that arp.coni anied by AIAS inn i ita an in oluotar ru-rale TRe new ublished raii: is shown aloria w Mi the . rcv ous i e WASI rat n .
DISCLAIMER
AHRI docs not ena.m. tna p.00uctis) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes Me nape”=Ibllity fop,
the product(s) list.d on :his Ceniflaa;e. AHRI azprtrssly aacl.lms all LaEillty vor damages of any kind arising out of the use or performance of the producttst, or the
urr..uth.rird alto—tion of d.la IL -ted on thiz Certifloet.. Ccrtifled mllev .re olid only f... models .no .on;lgar.;l.,nz list.. In efia
directory at www.ahridirectory.org.
TERMS AND CONDITIONS
Thi= Certifi.ale ..nd Its intents ..re propdct.ry products of AHRI. This Certifl..x h.Ii only Ile asoo;ur in4viva.I, pers.,nal and
confidential reference purposes. The c-;;t_ets of thia Csrtlfleete vwa,- net, In -hely or In part, be Nprodac.d; copied; diose I._ed; �
entered Into a computer database; or otherwise utilized, in any form or manner or by air,- m_.,rra, e.-wpt fw. the ■�;er' z indlade..l, r
personal and con.-.acnrl-.I rtrtr.noe. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION tlrr:
The information for the model cited on this certificate can be verified at---.shrldir_vt.r;..rg, ■1fek .n 'Yerif7 Certlfle..te' link IT, h�.rcr-
,Y, rri.6
and an;ar;lie nFIRI aerdrioa R.rore..ce Number and the date on which the certificate was issued,
:hleh Ir llatcd abw.e, .,nd the Certifl.-.;e No., which Is lia.va a¢ EE.wm rlQr.
02020AIr-Conditioning, Heatins, and Refrlreradon Inskku.e CEk i iFl%;Ai E Ru.: 132425036629734125
MicMalle Franklin, LFA -- Saint Cncie County Property Appraiser --All rlyhts reserved.
Pruperty Identification
Site rLduress:
r... -eel 10:
Account #:
map w:
U.,. '1 yFe:
mooning:
c:tr/Coe.raj:
OwnersRip
Ruth T Sp; -.go.
611 B.aek RD
Fon Pierce, FL 34982
Legal Description
HUNT'S SID 13LK B LOT 20 AND W 25 FT OF LOT 21 (0 25 ACS
Current values
ausl.'market va,ue:
$111,700
A=es3od valttc:
3111,700
Exemptions:
$75,000
t-..oDI� V..ltie.
336,700
Property taxes are soli;ect to chance ut,on
change of ownersRip.
• P -A t»..3 me notproj�ction „f fu:nr. t..xes.
• The sale of a propuny =ll p.. -..pt the .- -e-..I of =ll
cAcnipr;vrs, assess.�.ent caps, and special classifications.
axes for tnis parcei: SLC Toy Ce16to-', Of ii��
Lor..lvwd I KIM for .his parcel: Downloa-u PDF
611 BRACK RD
3403-701-0047-000-9
37aM
34.'035
0:00
RS -3 - Co-_
Sa:r.t Lac;c Cowuty
1 offal Flreas
rinislle=n'uernir Zsr): 8;6
Gras., Jlcctehcd A. -tea (sr}: 1,568
Land Size (acres: 0.25
Lasa 5:w (51`): 10,890
All information is believed to be correct at this time, out is suoject to change a :a is F"7 Z"" : anoat .-.T : a -_-utJ_
V C,opyrignt z&U Saint Lucie County r..pxrtT APM,„;,,p;, All .-:gnt.. ec„e.cd.