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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �` Permit Number: R CEIVED AUG 18 2021 �I.Lucie County crniffing Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: ,���, G•�lGL�.�tn� PROPOSED IMPROVEMENT LOCATION: Address: lg2 3 6AIAC14 Abk_ Property Tax ID M. ��' 7 �J�/5�(,�'3.30 Q�C�"s' Lot No. ..3 Site Plan Name: 21 (/IL/2 &?w Block No..� Project Name: DETAILED DESCRIPTION OF WORK: (-IK.f- rogL L/Ace RePG4 C,9Al" ' 0,0C 3 zZW 77Z4/C C77 New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION`INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond _Electric _Plumbing Q _Sprinklers _Generator _Roof Pitch /Total Sq. Ft of Construction: 6 1 1 Sq. Ft.of First Floor: Cost of Construction:$ D 110 Utilities: —Sewer —Septic Building Height: ;OWNER/LESSEE CONTRACTOR: . Name Name: mr- Address:o?7do2 sc CA=ze AIL Company: .4 411z Oevv, City:Alor fir Lvel-f- T7 State: Address: /L7%S•/A')& .�4'OUJ -�'- W Z 2 Zip Code: Fax: City AgAga- State: FL Phone No. 49 7- zl .72 Zip Code:, s-7 Fax: E-Mail: Phone No 77,2- 6lo?- 5_7 5Z) Fill in fee simple Title Holder on next page(if different E-Mail Ins���GJ 6��1 sa�r�•/KT from the Owner listed above) State or County License CAC 0, K%7 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. ,SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:, DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _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 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 paying twice for improvements to your property.A Notice of Commencement must be recorded in the public records of St. Lucie ounty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult witnen4ler or an attom6y before cgmmencing work or recording our Notice of Commencement. -tifnat of O Lessee/ on ct r as Agent for Owner STATE OF FLORIDA COUNTY OF s Sworn to or affirm d and subscribed bef me of Physical Presence or Online Notarization this 115 day of 2 by Name of person making statement. Personally Known OR Pro uc Identific ition Type of Ide ification Produced (Signature of Notary Pu I -State of Florida) Commission No. (Seal) �O1pt;Y P<,`�'�., AUDREY B.HUMPHREY .: y��} MY COMMISSION#GG 300817 s` ;�? EXPIRES:March 6,2023 t3onded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev Eligible for Federal Tax Credit s o 1 Certificate of Product Ratings AHRI Certified Reference Number:201170998 Date:08-16-2021 Model Status:Active Old AHRI Reference Number:7491808 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):RA1436AJ1 Indoor Unit Model Number(Evaporator and/or Air Handler):RH1T3621-TAN Region: Southeast and North(AL,AR,DC,DE,FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,TX,VA,AK,CO,CT,ID,IL, IA,IN,KS,MA,ME,MI,MN,MO,MT,ND,NE,NH,NJ,NY,OH,OR,PA,RI,SD,UT,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 -- _ . - 8,Air-Source Heat.Pump_Egwpment and'subject to rating accuracy by'AHRI-sponsored;?independent 'tfiird party testing Cooling Capacity(A2) ;Single or High Stage(95F),btuh`36000 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. Ratings that are accompanied by WAS indicate an involuntary re-rate The new published rating is shown along with the previous(i a 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 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; entered Into a computer database;or otherwise utilized,In any form or manner or by any means,except for the user's Individual, 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.: 132736000176008032 I