HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICAT101V TO BE ACCEPTED
Date: i-.��1 Perm, Numbe':
s
- Building Permit Application
Planning ond'DeveiopmentServices /
Building and Cade Regulation Division Commercial Resident`s I
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: JtV�g.'MRn�) Y\\J
Property Tax iD #: u) - Liat PR)L
Site Plan Name: BkKk ism
Project Name:
DETAILED DESCRIPTION OF WORK:
V'n� w',,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
1:7M#J js 5-�7 c
tb3�
Additi I work to be performed under this permit —check all that apply.
Mechanical _ Gas Tank Gas Piping _ Shutters ` windows, Doors _ Pcrrc
Electric w Plumbing _ Sprinklers _ Generator _ Rcaf per,
Total Sq. Ft of Construction:: � Sq. Ft_ of First Floor.
Cost of Construction: $ �sQA— Utilities- —Sewer _Septic &@sing Hetht
OWNERAESSEE: I LUNTRACTUR:
Name
Address:
t Cltj/: State: FL
_._._
Zip Code: � 75
Fax: /V
Phone No. 7 a . 1
Title Holder on next page ( if different
Fill In fee simple
from the owner listed above)
Name: -I&
Company:
—�
U _ .'..
AQGre$5: —
cjtY Sate:
Tip Code: S Fax: �, z
Phone No 1211q L• �'
E-Mail
State or County License C lk' R5�:�
rn
If value of construction is 2500 or more, a RECORDED Notice of C°mmenceern is regtdred.
If value of ""C is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ESIGNER/ENGINEER: _ Not Applkable MORTGAGE COMPANY: NApplicableat iicable
Name: Name:
Address: Address• State:
City State: City:
zip: _ Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
Address:
City:
Zip. — Phone:
SONDING COMPANY: _Not Applicable
Name-
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Appiicatfon Is hereby made to obtain a permit to do the wor[c andkat9lartliDn as
Inellicartect
l certify that no work or installation has commenced prior to the issuance of a permit_
SL Lurie County makes no representation that Is granting a permit will authorize the permto bvk-` the sabject strt-tire
which is in Coriflict with arty applicable Home Owners Association rules, bylaws or and covenants that may restrict or protxbr•, r ch
structure. Please consult With your Home Owners Association and review your deed for any restrictions w�— may 130*-
In consideration of the granting of this requested permit, I do hereby agree that I will, in ali respects, perform the wvrV
in accordance with the approved plans, the Florida Building Codes and St. Lude County Amendments.
The following building permit applications are exempt from undergoing a ful coneurrency review: morn additiGM
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residen'tia: use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying t'wk)e fn r
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, cartsu.t
with lender or an attomev before cornmencine work or recordine Your Notice of Commencement_
Signature of Owner/ Lessee/Contractbr as Agent for Owner Siignahrre of Conbac;or/lJcense Holder
STATE OF FLORIDAQJ_ ' I , 'r I R STATE OF FLORIIIA r
COUNTYOF �_ COUNTYOF
Swot o (or affirmed) and subscribed before me of
eaI Prese r Online N motion
this day of 2020 by
Name of persbn making stalement.
Personally Known V OA Produced Identification
Type of Identification
n
�of
(Signature Notary Pubk- State of FkxWo )
n
Commission No. (Seal)
9-7 (or affirmed) and subscribed before me of
Orri m Notarimtion
this of ZOZ by
Name of perso akirigstaterrterrt
Personalty Known ✓ Oe Produced kientifo=ation
Type of identification
Produced
(SignatureofNotary Public-5talr�Fid. �*
REVIEWS n R �a[iBTs R P1AN5 VEGETATION SEA TURTLE MANlGI�CVE
6lrlFn ssi n felii/ REVIEW REVIEW REVIEW REKi
IATE
,ECENED
ATE
;oMPLETED
v.
Eljgjble for Federa Tax C-ecr,
• CERTIFIED"
Certificate of Product Ratings
AHRI Certified Reference Number : 201278815 Date : 10-20-2021 Modes Statos Acttve
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) : RA1630AJI
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, MO. ME, Mi. MIN. MO. MS
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH. OK, OR, PA, RI, SC. SD. Thl, TX UT. VA. VT. WA. WV. III& Wy. U.S.
Territories)
Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be mstallied in all regions
until June 30, 2015 Beginning July 1, 2016 central air conditioners can " be nslaAW in regKOS) for
which they meet the regional efficiency requirement.
The manufacturer of this RHEEM product is responsible for the rating of this system combirraLon.
Rated as follows in accordance with the latest edition of AHRI 210240 with Addendum 1, Pertvrmance Rafting of UnAwy Airlbndieonrg
& Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent. Vwd party WS111 g:
Cooling Capacity (A2) - Single or High Stage (951`), bluh : 28600
SEER : 16,00
EER (A2) - Single or High Stage (95F) : 13.00
t"Active" Model Status are those that an AHRI Certificalion Program Participant is currently producing AND selknq or offerng kr sale: OR new rtrodels *W art ,any
th
marketed but are not yet being produced 'Production Stopped` Model Status are those at an AHRI Cerbhcahon Program PartuXxam a no horxger trx*mwq BUT is sss
selling or offering for sale.
nafirics that are jccQml;iprliedby WAS indicate n inv lunt r -r I. The new oubipshedshown akrig with 1 u,%
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, end assumes ne reepxagiiiiI far,
the pro-duct(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind ansing out of the use or perlivmence of the pra&m%sl at 9w
unauthorized alteration of data listed on this Certificate. Certified ratings are valid onf} for models and configuratk ns listed in the
directory at % ww.ah rid ltectory.o rg
TERMS AND CONDITIONSAt �i
This Certificate and Its contents are proprietary products of AHRI, This Certificate shall only be used for indhidual, personal arrd
confidential reference purposes. The contents of this Certificate may not, In whole or in part, be reproduced: copied, cimseminaIt
emu
entered into a computer database: or otherwise utilized. in arry form or manner or by any memos, except for the user's mtlAMual.
personal and conndential reference. AMF N)F4gNI ti % 'OL WM%Tgft
CERTIFICATE VERIFICATION A ERA"MOSTIT fi[
The Information for the model cited on this certificate can be verified at www.ahrld lrectorv.otR, dick on'Vii-WN Ce tN'c nt" fink �e anatie brmw-
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 night.
13279Qf1y65�07f'9Q
02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE Nl