HomeMy WebLinkAboutBuilding Permitru yr r►rsi door:
ifities. SewerSeptic Building Height:
OWNE
L ESS E E:
Name_ _ — ••
Address
City:
Zip C
ALL APPUCAilLE INFO MUST BE COMPLETED
Date: I... Q�l
BuIldf
rronning and Development Services
Building and Code ReglAlUon DMIon
230o Virginia. Avenue, Fort fierce FL 34982
APPLICATION TO BE ACCEPTED
Permit Number:
Permit Application
none: (172) 462-1553 Fax: (772) 462-1578 �I Commerc0
ial Residential
PERMIT App��CATION FOR. T„
!r oropnox, c��ck arrow at the end of tine
PROPOSED.IMPROVEM-ENT.-LQCATIONr
Address: A
Legal Description:4�LC' C
7 7 --- 3 L��
Property Tax ID #:
Lot No.
Site Plan Name:
Project Name: Block No.,
Setbacks Front Back*•
R'0 tS!de: Left Side:
FDETA!!FD DESCRIPTION -OF -WORK:
' f- �..J i ice' c�
C C.
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coNSTRUCTION lNFQRMATION:
Ad cartrona wo obe enorme u n"cier twws m check aM-Shutt
apply,
Y:
H
VAC Gas Tank p 8 ers 13windows/Doors
Electric 1:1 plumbing Sprin I rs � Generator
Roof Roof pitch
Total Sq. Ft of Construction,,
Cost of Constructow, I
ode:
Phone NoROMWE"ft .� _ 7,�,�—, �S �
E-Mail.-
Fill in fee s-vmplp Title Holder on next page (if
from the Owner listed ahnve)
1"
64 medw
*JL� C-d0000f
AW
;tae,
If value of construction is $25QD or more, a REC�7RDEp
Company:
AOCIreSS:
Ity-44
Zip Code: �3 �-/ g x- ?-
Phone No. r'""X
&Malllp: C oci
State or County
W� 11-/
EMMENNOM
License:
of Commencement is'required.
Fax:
1h47
ef 400
QWP
state:,.�L
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SUPPLEMENTAL CONSTRUCTION LIE LAW INFORMATION:
DESIGNER/ENGINEER: _Not Ap Ica ble MORTGAGE COMPANY
Name:
Address:
City: . M-- Stat
ZIp: Phone
FEE SIMPLE TITLE HOLDER: Not AP
Name:
Address:
City;
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: App 1catio
certify that no work or installation has commenced
Name
Addre
SS:
C a I t y State:
zip: Phone*
lb
10 _Not Applicable
cable BONDIU Dpf0
Not Applicable
Name:
Address:
City:
Zip: Phone:
hereby made to obtain a permit to do the work and ins ation as indicated.
for to the issuance of a permit.
St. Lucie Count makes no representation that is gra ng a permit will authorize the �errnit holder to build the subject structure
which is in con�ici with and applicable Home owner ssociation rules, bylaws or and covenantsthatstructure. Pease consult with your Home Uwners As ciation and reviewyour died for an restr�tns whi h may prohibit such
� Y pp Y•
Inconsideration of the granting of this requested per it, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Bpi dingy Codes and St. Lucie Count Amendments.
The following building permit applications are exemp
accessory structures, swimming pools, fences, walls,
WARNING TO OWNER.* Your fall r Record
improvements to your property. A Notice
Lucie County and posted on the jobsite b
with fender or an attorney before comma
Signature of owner/ Lessee/Contractor as Agent f 0
"�
undergoing a full coneurrency review; room additions,,ifrom
ns, screen rooms and accessory uses to another nary -residential use
Notice of Commencement may result in paying twice for
of Commencement must be recorded in the public records of St.
"ore the first inspection. If you intend to obtain financing, consult
icin9work o1 --r recording your Nonce of Commencement.
V
caner ( Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ S i � � G,� COil MUNTY OF S ; L0�e.o
Sworn to (or affirmed) and subscribed before me of
"physical Presence or Online Notarizatio
this -XI day of e_.. 202f by
--� c.�`~�//' C, ram-- _. (1:-4�
Name of person making statement.
Personally Known OR Produced Identificati
Type of Identification
Produced
(Signature of Notary Public- State of Florid)
COMMission N.
REVIEWS
COUNTER
DATE
RECEIVED
DATE
Iiwlpllllm
SAY 1 �AGtte
$tart' Pu 1c- aof
Commission # GG 2'
REVIEW
�3
Sworn to (or affirmed) and subscribed before me of
�j ysicai Presence or Online Notarization
this day of r0 �-..01 202$ by
Name of person making statement,
Personally Known OR Pro
Type of Identification
Produced
duced Identification
(Signature of Notary Public- State of Florida }
Commission
`I rid
�s
R PLANS
EW REVIEW
A L
4' OR GA5�1"Ewl---
Notary Public -State of
Floridar* %1, ^
441
Commission Expii es
RTEE23 Nib
qGROVE
VIEW
Eligible for Federal Tax Credit
Certificate of Product FZatinas
AHRI Certified Reference Number : 90261839
Date : 6 -21-2 21
AHRI Type: RCU A -CB (Split System: Air -Cooled Conder�sing Unit, Gail with Blower)
Outdoor Unit Brand Name: FUJtTSU
Outdoor Unit Model Number (Condenser or Single Packaje) : F03616CSJ
Indoor Unit Model Number (Evaporator and/or Air Handler : FH3617TTS*SN
Mode! Status: Active
Region : All K, AL, Aft, AZ, CA, COT CT, D I DE, FL, G& HI, 1131 N L [Al IN, KS, KY, LA, MA, MID, ME, MI, MNI M07 MS,
MT, NC, ND, NE, NH, NJ, NIVI,loll, Y, 0113 OKf OR, PA, RIO SC, SID, TN, TX, UT, CIA VT W
Territories)
Region Note : Central air conditioners manufactu�rprior to January� 20 �are eligible to be installed in all regions
until June 30, 20 6.BeginninJuly , 2016 central air conditioners can onl installed in r `
� � � fo r
which they meet the regional a cie c requirement.
The manufacturer of this FU,lITSU product is responsible 4r the rating of this system combination.
Fated as follows in accordance with the latest edition of A
Air -Source Feat Pump Equipment and subject to rating
Cooling Capacity (A2) -Single or High Stage (95F), btuh
SEER: 16.00
EER (A2) -Single or High Stage (95F) : 13.00
f "Active's Model Status are those that an AHRI Certification Program I
marketed but are not yet being produced." Production Stopped" Model
selling or offering for sale.
F afifts that are acc mr)a ni d b _WAS indicate an invoiuntar re -Date.
1 210/240 with Addendum I , Performance Rating of Unitary Air -Conditioning
cu racy by AHRI-sponsored, i n ep ndeft, third party testing:
200
artici ant is currently producing AND seising or offering for sale; OR new models that are being
Status are those that an AHRI certification Program Participant is no longer producing BUT Is still
The new published rati no i shown alom
a with the Fre i
'i.e. s) rating.
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and rr Eikes no representations, warranties or guarantees as to, and assumes no responsibility t for,
the product(s) listed on this Certificate. AHRf expressly disclaims all I ability for damages of any bind arising out of the use or performance of the
p p oduct, or the
unauthorized alteration of data listed on this certificate. certified rat .n s are valid only for models and configurations listed in the
directory at www.ainridire t r .or *
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRL Thi certificate shall only be used for individual personal and
confidential reference purposes. The contents of this certificate may ot, In whole or in part, be reproduced; copied; disseminated;
entered into a computer database; or otherwise utilized, in any fora r manner or by any means, except for the user's individual,
personal and confidential reference.
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at ww.a ridire for .or , click on "Verify ertificate" lira
and enter the AHRI Certified Reference Number and the date on whi h the certificate was issued,,
which is NCI -MA b d h c
AIR-CONDITIONING, HEATING,
c REFRIGERATION INSTITUTE
we make life l ett r,I,
@2021 Air -Conditioning, Heating, and Reffigerationj Institute CERTIFICATE NO,-* 1326$7877011246172