HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Tta BE ACCEPTED
Date ,: Permit Number :
17
A Building Permit APPI ication
Planning and Development Services
Building and Cade Regulation Divt"si on Commercial Residential W111
2300 Virginia Avenue, fart Pierce FL 34982
phone : (772 ) 462,omIS53 pax : ( 772 ) 462v* 1578 CBDG Funding
PERMIT APPLICATION FOR :
S E D I MPROVEMENT L�ICATIQN :
NOW. Q � i d - K � �r �- � . c.� c . e1. 3 t � DIM.-
Address .Property Tax ID #*4 Lot N o .
Site Plan Name : l� � Q 4 S � C Block No .
00000" i - wom-
Project Name : Q RS a( G � �
C3ETAILED DESCRiPTt4N 4 � WORK *
L XP
Lon)
New Electrical Meter Second Electrical Meter (Affidavit required )
C� NSTRUCTlON INFORMATION :
Additional work to be performed under this permit -- check all that apply:
✓Me c h a ni ca l r Gas Tank _ Gas Piping � Shutters � Windows/Doors .� P o n d
i Electric ^ P l u m b i n g SP ri n k l e rs ,_,_ Generator Roof Pitch
Total Sq . Ft of Construction: Sq. Ft. of first Floor ;
Cost of Construction : $ Jr� 040 � a Utilities : Sewer Septic Building Heig_Pffi_ _P1
ht :
QWNER/LESSEE : CONTRACTO RP W 00 .. . . . . ---,F:md *w0h1q. __E*00
Name3 0 � h ( p 0. S c� Q � L N a m e : I/J a h �e os k ;Address : � �t A Ck✓- ► a� � h Company : Tl. M �o� �S �rc.� �,t 1�-t c+c � eta.
City: �01( � S+- kA COL e State : `Z.. Address :: 1 � l Se ► ixs �+' ah �StJeL
Zip Code : � �[ 9„ 51- , Fax : City: A .1, 1, N—Lei#+ an State : FL
...
Phone No . 8 - 5 5 g 5 E- Zip Code :
9 1 N_ WIN P-Mm. 0 . -0 MN.--_04WOUPOOMMM
Mail : Phone No r12!>M -
Fill 1*n fee Ammple T*Itle Holder on next page (if different EvwMail �.. p �QM :�Q r,� v� a r �1�s a �OO • �
from the Owner listed above) I—
State or County License
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,SOO or more,, a RECORDED Notice of Comrnencement is required.
MOM
PERM
SUPP- .ENf �fi�Tt�L CC�NSTRU' CT-. iQ�i LIE1� LA.W INFf}RM1�TtQ�t
GNEIVENGINEER. Not. APP11-cowable MORTGAGE COMPANY: Not Applicable
Name .
mom' No . Name :
AddreSS* _ Address •
City: - --�� State Cst
9ty � State •
dip: _ Phone Z 2 � . P
SEE SIMPLE TITLE iHOLDERn Not Appl *icable BONDING COMPANY: Not Applicable
ame ., - Name:
Address ,, Address .pity CFI' ��.�m
POW
ZIP • Phones Zip: Phone,
MEW~
Eikd COPTRAITOR �FFiDi/iTe Application is hereby made to obtain a permit to do the work and installation as indicated .
I ceirtify that no work ort"nstallat'on has cgmm2nced prior to the issuance of a permit,
St. Lucie County mikes no representation that is granting a permit wilt authorize the permit holder to build the subject structure
which conffi'cts with any annitcable Homeowners Association rules, bylaws or and covenants that may restrict c)r prohibit such
structure. Please consult with your Homeowners Associabon 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
iro accordance with the approved plans, the Florida wilding Codes and St. Lucie bounty Amendments.
The following ti�'sading permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,, swimming pools, fences, wails, signs, screen roams and accessory uses to another non-residential use
WARNI Your lure to ecord a Notice of Co- mmencemen# may result in paying twice for
improvements to your property, A Notice of Commencement mast be recorded in the public records of St.
Liuce County and pasted on tin jobsie �e before the first inspection, if you intend to obtain financing, consult
WItFt I� fi�� l' OT 8C1 ��Or�@ before comr��nc� n work or recordir� our Notice of Commencement.
Signature of Owr(ei/ Lessee/Co ractor as Agent for Ownc .,
STATE OF FLORI
C U OF V t r
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of S t C o6^ 15 oc )C .. , 20,E by
�Mame of pers' on making statement,
Personally Known ✓ OR Produced Identolficat'ion
Tye f Ident'I'ficat'lon PrP I _P I I —— I- .- 't I 20 ,042r. 41 . 1 ' ti-10"i m4asm=
uc�d
(Si nature of tary Pu tic- State of Florida )
Commission No. r7 � (Seat) KELLY M BECKERT
�`� ' •eU� MY Co MtAiSSION #GG1 59976
� z r EXPIRES: NOV 14 , 2021
Gd�of Bonded thro ugh 1 st State Insurance
REV I �.���S FRON� ZONING SUPERVISOR FLANS VEG SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW R E V I F!�V REVIEW REVIEW REVIEW
'SATE
RECEIVED
DATE
COMPLETED
Rev--5/2
Eligible for Federal Tax Credit
■ o
s
Certificate o P rod u ct F a Ill S
AHRI Certified Reference Number : 201340983 Date : 09-01 -2021 Model Status : Active
Old AHRI Reference Number : 1076061
AHRI Type : SPY-A (Year-Round Single-Package Air-Conditioner, Air-Cooled)
Series : RHEEM RSPM SERIES
Outdoor Unit Brand Name : RUUD
Outdoor Unit Model Number (Condenser or Single Package) : RSPMwA036JK
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
anti [ 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 RUUD 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 : 34200
SEER : 14 .00
EER (A2) - Single or High Stage (95F) : 12 -20
V'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 bv WAS indicate an involuntary re-rate. The new aublished rating is shown along with the previous ( i.e. WAS) rating.
DISCLAIMER
AHRI does not endorse the product(s) Fisted 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 (lability 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.ahridireotory.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; �i ■� ��
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 i nform ation for t h e m odel cited on th is certifi cate ca n be ve rifi ed at www,a h ri di recto ry.o rg, di c k o n "Ve rify Ce rt if i ca te" l in k 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-Cond 'itioning, Heating, and Refrigeration InstituteCE� RTIFICATE NO . :
132749968137722312