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HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -7 / ZS I Z- I Permit Number: .`� LPL: �Ow .. Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential K_ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: H V A ( Nl ec,Ir�tN CCU l � C,Q�ccwt PROPOSED IMPROVEMENT LOCATION: D k_ Address: Property Tax ID #: Site Plan Name: Pay `' I� Project Name: V t't C ni4vr(ebU_A- U DETAILED DESCRIPTION OF WORK: Lot No. L(10 Block No. UA nl[Ca 1 A l hQ M _TON 1, SEES- W J S k-W HEA P-- STF-A(Cn HT- CWLy N ET L l k_E FUL U k-E New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: X Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ LIJ Z CZ _ Generator _ Windows/Doors — Pond Sq. Ft. of First Floor: _ Roof Pitch Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Address: b i City: PC" S� . State: _EL Zip Code: 34R& Fax: Phone No. 132 $ - Ap(vq E-Mail:�5(nr. t' V A ISO coo-V • Cb Y1(N Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Qcrtosiw Company: C Address: 13 $q (UW COMr1 City: P6r t , Tl. Lu C Ie. Zip Code: 34g8(p Fax: Phone No % 00 0740 UCt C rntYe- D State:_ E-Mail Wrlemp (2C a hoo. cam State or County License CALttlLl 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. r SUPPLE MONTAL ONSTRUCTION LIEN LAW INFORMATIOM . INEER: _ Not Ap Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: � Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: � Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City. 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 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 ofthis 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in 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 attornev before commencing work or recording your Notice of Commencement. Signature of Owner/ Lessee/C 'tractor as Agent for Owner STATE OF FLORIDA COUNTY t}F J Sworn to (ar affir d) a d subscribed before me of Physical Presence or X Online Notarization this day of 20 2 1 by Name of person snaking statement. Personally Gown X OR Produced identification Type of Identification Produced (Signature of NotaryPujblliicc-- Sttate of Florida (P} Commission No. l 1 � 1 f044 WTgtSeal) REVIEWS I FRONT ZIJNING COUNTER REVIEW DATE RECEI) DATE COMP Notary Public State of Florida Brianna V Lorenz +� MY Commission HH 042089 Expires09114/2024 SUPERVISOR I REVIEW PLANS I VEGETATION I S REVIEW I MANGROVE Eligible for Federal Tax Credit Certificate of Product Ratinas AHRI Certified Reference Number: 201278815 Date : 07-22-2021 Model Status : Active Old AHRI Reference Number: 7940903 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RHEEM Outdoor Unit Model Number (Condenser or Single Package) : RA1630AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-21 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 RHEEM product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 with Addendum 1, 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 : 28600 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 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 Participant is no longer producing BUT is still selling or offering for sale -accompanied by WAS indicate an involuntary re -rate. The new published rating is shown along with the previous (i.e. WAS) ratino. 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.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;r�l� entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, i 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.ahridirectory.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. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132714594866745131