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HomeMy WebLinkAboutBuilding Permit Application �4', .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not App(icabl'e
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.
f certify that no-work orinstallation has commenced prior to the issuance,of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto 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 Horne 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'F{orida 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 paying.twice for
improvements to your property. A-Notice of Commencement must be recorded:in'the public,records of St..
Lucie Cou y and;posted on the jobsite before the first inspection. If you intend to obtain financing, consult.
with len a or-an attorni-v before commencing work or recordirAvour Notice of Commencement.
Signatu a of owner7 Lessee/ ontractor as Agent for Owner Signature of Contra or/License Holder .
$TATE,OF FLORIDA )) STATE OF FLORIDA
C.OUNTY'OF_ �4• h�� j � COUNTY OF., S4-
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of 201� by' this day of 2oarby
Name ofperson making stateMent. Name of person making tatement.
Personally Known r OR Produced Identification Personally Known OR Produced Identification
Type of identification Type of Identification
Produced____,,..-,- Produced-
AUQREYB
.•�v,Fa' '
a`- �; HU NREM ;oitE�.Kt?4r; AUDREY B.NUMPfiREY
YC
(Signature of `{ic-SIR�tIM.mlecct 423 - (Signature of Nota at
Bonded Thru Notary Public tfidetwrit_rs e � �' a1.2
ICti fi,2423
Bonded Thru Notary Public Underwriters
Commission o, ea Commission No.
REVIEWS FRONT. ZONING . SUPERVISOR . PLANS' VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO�BE ACCEPTED
Date: 1;�� • T Permit.Number:
Mz—
. BuildJrng Permit Application
Planning and Development Services 1
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Port Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERM ITAPPLICATION FOR:
mom
Address: 17� 9 ! P tyl e C.Y-'2215
Property Tax ID##: 53 Lot No.
Site Pian Name: Block No.
Project Name:
11111
_ K. � ... „ '.».. •err- ,. .�e .�
A C. ~01 a»*q! *c. O(At Puu4 4 TdA wv 44 7 i.5 K,w-,
NUvJ U r-a.'h ei. v1 , re vh aa%CA &A
t5 SEER
New electrical Meter Second Electrical Meter
sd• �ar,f�¢ 3 't„
t7,'y ,°-+y- t ,t FD" ,:a� �' �„. 3 �� a 4 b �•.� , ��' "2�t'.;�m �`� 7�i�`.xi' t!
..1_ a Ne;Y�.. ;a.%a�S.. .3i+.PT.-S:h '' 3_ .,K'.lc. .x•ia•n•''.tet.y�+,.. '��i .•.. 'C '•' "` ~sii �. .. 'A.
Additional work to be performed under this permit–check all that apply:
Mechanical —Gas Tank ^Gas Piping Shutters T Windows/Doors _Pond
_ Electric Plumbing Sprinklers `Generator Roof Pitch
Total Sq. Ft of Construction:t Sq. Ft. of First Floor:
Cost of Construction.$ DC7 �--d� Utilities: —Sewer —Septic Building Height:
._.�..,;_^;•c++•n�.-_ .�.�;- ,xray- '•:„ ....�,. v:.tix�j�;ikr'tau:+ ^.?'tts'�I::R�..?.-�"'A.. ';�;'tti ra..,w,gen-. .rp�.•v.�WitEc.,;+;.Cc:"v,.,,i.
:xiVs„�
.v. r t ,,"'M'.N cj A°�.4xi 1 LZr'k,.Sr. �'i "+C.c by v�i5.., t .✓" tit '1�?}.'rt�'n i��. y�x ...`"+• as7t k;;i
:¢cC. �. ,�� ati�T. xC�'t,' _•z^7 p:����Sk�;:•����L:d•:n�. :i}.,�^,,`f� =�` ��1w17h�, (�' �� r =N�� ' ,rMr�-`�4'y�- ct+ t••�I �T,:,a� �
4+I "�.�... �/fL-iw !ci ;" rie�.�c.� :4k '•:7,:y?!""r,,.,ct.x".i2n�.{ 'c- w•rSiki � +fan= l!Y � h. 'i�Rtiac,'3^r.'-4 y?.'. + .. � 'S�pw_vtt= w: i #Ssc�• -'i��t
e;1t'3�i'F;i^.�Snru:a�.�?^_{a,•i�•�3 �-�.fi��a."'�?,a�al;��,j':�y. 2fi7r'�,�.'r��xt.�`a : :E�t�.'4.��#n .� ....�Xd ��"�Y.•Lia •.n:�.R:uC.��.:YvfP�.��'...•..�a..=Xll�tiur'.._�'`"•.c�i..: ,t:._.sc��.
Name M Kr bs, W t'%1±erY', Name: U Kt to Y1
y bu T •
Address: 7��� pine C.Ye�k t1��Y Company: {'i^tT �• �• h Y �»
City: . S , L .! State. Address: ;_Lz N.vJ• L-o VoY Ct v
Zip Code: W4 Fax:— City: P \ S ��..
• L, _State:
Phone No. q r) ter
z S 'X q 9 Zip Code: �1 ~���. Fax: (� '
E-Mail: Phone No �i' — 70 1
Fill in fee simple Title Holder on next page (if different E-Mail Gt't"*0,1 el C.tlU VI-rf tt OrM6,i J.�.b�'l
from-the Owner listed above} State or County License Cr�C.1 81 �7 3.5'
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
i6
I
.DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: 1 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'installat"son 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•accgrdance 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,p�aying.twice for
improvements to your,property. A•Notice of Commencement must be eecorded.1n'the public records of St.•
Lucie County 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 recording our-Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Oniine Notarization Physical Presence or Online Notarization
this day of 20_,__ by, this day of .20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identification Type,of identification
Produced Produced
(Signature of Notary Public—State of Florida). (Signature of Notary Public-State of Florida
Commission No. (Seal) Commission No. (Sea[),
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION _ ;;SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED`
DATE .
COMPLETED
ev.
I
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i�.
l3 E
Www.a i
Certificate ®f Product Ratings
AHRI Certified Reference Number:201176357 Date:09-04-2020 Model Status:Active
Old AHRI Reference Number:7493661 ;
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AHRI Type:RCU-A-CB(Split System:Air-Cooled Condensing Unit,Coil with Blower) a
Outdoor Unit Brand Name:RUUD
Outdoor Unit Model Number (Condenser or Single Package):RA1448AJl ' I
a ;
Indoor Unit Model Number(Evaporator and/or Air Handler):RBHP-24 f ;
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)
1 f'
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. E
B
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 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: f
Cooling Capacity(A2)-Single or High Stage(95F),btuh:45500
R6
SEER:15.00
EER(A2)-Single or High Stage(95F) : 12.50 r
i
€
(a
1
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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 R !'
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 F
selling or offering for sale. € '
Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the previous(i.e.WAS)rating. '
DISCLAIMER 4
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
I,
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, C
personal and confidential reference. AIR-CONDITIONING,HEATING.
&REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATION i
The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make life better- 4 ''
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.
132436992776845585
©2020Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: �.
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