HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F
Date: % e
Build!
Planning and Development Services
Building and Code Regulation Division
23W Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: To Select
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setback F
APPLICATION TO BE ACCEPTED
Permit Number:
Permit Application
Commercial Residential
/ Lot No.
Block No.
s rant Back: ht Side: Left Side:
DETAILED DESCRIPTION OF WORK:
12- cp G< �D .�-� %� ILA A
� % �,''� � '` � S �'•- � �'-�- c� sew-, `._,..P t�
CONSTRUCTION.,IN,FORMATI.ON:
�Uona wo toe a rmarl sin et
r is pe
HVAC Gas Tank Gas
FElectric 0 Plumbing �Spri
Total Sq. Ft of Construction: %
Cost of Construction: $
— c ec a apply:
ing _ Shutters Windows/Doors
tern � Generator Roof R
So. Ft. of First Floor:
Utilities:[]Sewer L _(Septic Building Height: eight:
itch
OWNER/LESSEE:
Name 1� L
Address: _ , _ i
City' Statel
CC "NTR kCTOR:
Name: ! ��
Company;
L66 Address:
Zip Code: � =-/ Fax:
Phone No. Q - 2
Fill in fee simple Title Holder on next page ( if difi
from the Owner listed above)
if value of construction is $2500 or more, a RECORDED
e.raC .--
City:5—� _State:_E
_ Zip Coile:.l Fax:
Phone No. `7` .J
E-Mail• C (,, , C (_ 3 �,1 r) t... 0 7�
State or County License: _(f, A c�/
of Commencement is required
- _ _.V%.•y«•vnvccK: Not
Name:
City:
zip:
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Address:
City. -
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application
1 certify that no work or installation has commenced
St. Lucie Count makes no representation that is gran
strlucture, Please c nsult withpyourr Nome OwnOers Ass,
In consideration of the granting of this requested perr,
in accordance with the approved plans, the Florida Bu.
The following building permit applications are exempt
accessory structures, swimming pools, fences, walls, si
WARNING TO OWNER: Your failure to Record
`improvements to your property. A Notice of t
before the first inspection. If you intend to ob
re of Owner/ Lessee/Contractor as Agent for
STATE OF FLORIDA
COUNTY
The for�o_ing instrument was acknowledged before
this I l- day of /fie_ (20::�L by
�a
Name of person making statement
Personally Known OR Produced identification
Type of ldentification
Produced
(Signature of Notary Public- State of Florida j
TAYLOR GA
II1io-State of Florida
ComirnissfOf P GG 293167
MY COMMigsion Expires
REVIEWS FRONT — ZONING
COUNTER REVIEW
Rev.8/2/17
Zip:
hereby made
or to the issu
f COMPANY: Not
State:
Phone:
COMPANY: _Not
obtain a permit to do the work and installation as
e of a permit.
a permit will authorize the ermit holder to build the subject strucl
ociation rules,bylaws or anc�covenants that may restrict or prohibii
ition and review your deed for any restrictions which may apply.
I do hereby agree that I will, in all respects, perform the work
ig Codes and St. Lucie County Amendments.
m undergoinga full concurrency review: room additions,
, screen rooms and accessory uses to another non-residential use
otice of Commencement may result in your paying twice for
)mencement must be recorded and posted on the jobsit
n financing„ consult with lender or an attorney before
)IT mPnrarv,inn+
of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ; L
The forgoing instrument was acknowledged before me
this I ._- day of _- c� ( 20
LL by
name or person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary PuhiFr_ c+.+o 7F
Commission No `, TAYLOR GAGNE
blic-State ,c
(
ion # GG 2931'67
�AT
r4 th\
mission Expires
January 21, 2023
PLANS VEGETATION SEA TURTLE MANGRO
;EVIEW REVIEW REVIEW REVIEW
Eligible for Federal Tax
N
a I ft�� se M�
AHRI Certified Reference Number: 201285854
Old AHRI Reference Number: 3588628
AHRI Type: SPY -A (Year -Round Single -Package,
Series: RHEEM RSPM SERIES
Outdoor Unit Brand Name: RHEEM
Outdoor Unit Model Number (Condenser or Single
Region: All (AK, AL, AR, AZ, CA, CO, CT, E
I'VIT, NC, ND, NE, NH, NJ, NM, NV,
Territories)
Date: 08-19-2021
, Air -Cooled)
RSPM-AO43JK
Model Status: Active
DE, FL, GA HI, ID, IL, 1A, IN, KS, KY, LA, MA, MD, ME, IVII, MN, MO, MS,
OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S,
Region Note: Central air conditioners manufacturid 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 efficie icy requirement_
Themanufacturer of this RHEEM product is responsible fc r the rating of this system combination.
Rated as follows in accordance with the latest edition of Al IRI 2101240 with Addendum 1, Performance Rating of Unitary Air -Conditioning
& Air -Source Heat Pump Equipment and subject to rating ccuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh -. 10000
SEER -. 14-00
EER (A2) - Single or High Stage (95F) : 12,00
Active" Model Status are those that an AHRI Certification Pr(
marketed but are not yet being produced."Production Stopped'
selling or.offering for sale,
DISCLAIMER
AHRI does notendorse the product(s) listed on this certificate and
the product(s) listed on this Certificate. AHRI expressly disclaims a
unauthorized alteration of data listed on this Certificate. Certified I
directory at www.ahridirelatory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. I
confidential reference purposes. The contents, of this Certificate in
entered into a computer database; or otherwise utilized, in anyton
personal and confidential reference,
CERTI F1 CATE VERIFICATION
The information for the model cited on this certificate can be verlil
and enter the AHRI Certified Reference Number and the date on w
which is listed above, and the Certificate No., which is listed at hot,
Og 2021 Air -Conditioning, Heating, and Refrigerati(
'arficipant is currently producing AND selling or offering for sale; OR new models that are be ng
Status are those that an AHRI Certification Program Participant is no longer producing BUTIs still
; no representations, warranties or guaranteesas to, and assumes no responsibility foli
lytor damages of any kind arising out of the use or performance of the product(s),
are valid only for models and configurations listed in the
Is Certificate shall only be used for individual, personal and
not, In whole or in part, be reproduced; copied; disseminated-.
or manner or by any means, except for the user's individual,
AIR-CONOMOKI
NG, HE NG,
t
REFRIGERATION 114ST TFE
I at www.abridirectory.org, clickon 'Verify Certifir-ate" link wL iwke Kv bet, er'
ch the certificate was issued,
n right. 13 — M 0
I Institute CERTIFICATE NO.: 13273844390171 571