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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: n 3, a0aa- Permit Number: 55'ro [LUM0 cn- 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 PROPOSED IMPROVEMENT LOCATION: I Address: Property Tax ID #: 4-S-c a _ l ` i 3a ! - coc) - Lot No. Site Plan Name: C r j m iLr- i Block No. Project Name: C rn m-ct DETAILED DESCRIPTION OF WORK: R� c 1, SC C Yam_' [ (p lnl "�'Q-LO1- New Electrical Meter Second Electrical Meter Additional work to be performed under this permit -check all that apply: Mechanical Gas Tank —Gas Piping _ Shutters — Windows/Doors Pond _ Electric _ Plumbing , Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ �D Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNERAFSSEE: CONTRACTOR: Name C--N� d o r 'C_G.M-e 1- c Name: c �. . Address: k\k!� 1\1-C -eS _\?)�\f d Company: 686u-,-raid Co-cii Air , City: c- s-cx ' -p-'ea-Ch State:- Zip Code: 3L'QS-1 Fax: Phone Nol-Aa-71-1 Address: -�f N�aB City: >'ar_: t-_nt, State: 7L_ Zip Code: Phone No Q71_ 2_:` to E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) I E-Mail State or County License Coe 19 5 '1® 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. ,.42,1 ` Z 4 e Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA Lkm COUNTY OF � C1� STATE OF FLORIDA COUNTY UACi C subscribed Sworn to (or affirmed) and before me of Physical Presence Online Notarization Sword to (or affirmed) and subscribed before me of / Physical Presence Online Notarization or this day of U 202�by _ or thin 202{�--by \ O ��d1ay`of�}� J.JUQ ` (A � Name of person4iiakingstatement. Name of person aking/statement. Personally Known \// OR Produced Identification Personally Known V OR Produced Identification Type of Identification Produced Type of Identification Produced (Signature of Notary Pubtie3$G to of F HEFWANpEZ (Signature ofTNotf-'1P_"_' i �ta141�d6 MY COMMISSION # W6; M598 Commission No. :1 �` EXPZl g" 2025 "' Bonded ;NotaryP b cUnderwrhws ;. Commission No. F- A' ThruNof �t�lh�denrrit�rs REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Certificate of Product Ratings --No� AHRI Certified Reference Number: 201174989 Date: 01-03-2022 Model Status: Active Old AHRI Reference Number: 7492558 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) : RA1448AJ1 Indoor Unit Model Number (Evaporator and/or Air Handier) : RH1T4821STAN 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 - 2017 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 : 45500 SEER: 15.00 EER (A2) -Single or High Stage (95F) : 12.50 1"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. RaGnos that are accompanied by WAS indicate an involuntary re -rate. The new published rating is shown alona with the previous !i e WAS' at ng 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-ahridire ctory.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; .■ t� entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the users individual. personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information far the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, p mate life tx er^ which is listed above. and the Certificate No., which is listed at bottom right — - ©2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132856961418777404