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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � �� Permit Number: ��'i �. L! �UL =:ft Q 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 CBDG Funding PERMIT APPLICATION FOR: I PROPOSED IMPROVEMENT LOCATION: Address: iOrICi SE, �b den VX Property Tax ID #: Site Plan Name: _ Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Electrical Meter Second Electrical Meter 3`Ac1SC3 (Affidavit required) Lot No. Block No. CONSTRUCTION INFORMATION: I Add7echanical al work to be performed under this permit - check all that apply: _ Gas Tank —Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: OD Cost of Construction: $ R. a _ Windows/Doors — Pond Sq. Ft. of First Floor: Roof Pitch Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name ' Name: U01VYL. Address SC City: Ps 1 _ State: Zip Code: Fax: Phone No. SCP k '-( j23�-A _LP 3q- E- Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Company: Address: U 5_ E I I 17b C,�"r City: Psl- State: ,C-1- Zip Code: 3QOf Ti Fax: Phone No L-) E-Mail 07 S ccok N C om State or County License Cf� L 3 a C) l.P D if value of construction is z5uv or more, a Ktl.UKuty ryvucn up wnnncnwu.cna .a . oya... c... If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. i PPLEMENTAL CONSTRUCTION LIEN LA EORMATI N: DESI /ENGINEER: Not Ap able MORTGAGE MPANY: Not A icable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HO ER: � t Applicable BONDING COMP Y: Notlicable 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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: our failure to Record a Notice of Commencement may result in paying twice for improFn _ ents to your property. A Notice of Commencement must be recorded in the public records of St. Luc y anosted 9fi the jobsite before the first inspection. If you intend to obtain financing, consult wit ler or aiYattornev before commencine work or recordine your Notice of Commencement_ 1 i Si ure of Co ctor - o wner Builder as applicable I STATE OF FLORIDA COUNTY OFC.�-�_ Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this ay of 20.'Zj by V 'lld Wam oe Lc�C_Lny_�4- -T4-. Name of person making statefnent. Personally Known OR Produced Identification Type entification Produced _ (Signature of Nota blic- State of Florida) n Commission No. 1414 1 Orl"f eal) �:+�c�, a...: ASHt:! KENN: SF', Notary public - sutc c %'orica Con. mission#HH'C7565 ^- ate• µy Comm. Expires Mar . 2025 soncec through -4ational N:: _ y Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED RCV 1V/1L/L1 Certificate of Product Ratings AHRI Certified Reference Number: 201168366 Date : 12-20-2021 Model Status : Active Old AHRI Reference Number: 7491226 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RUUD Outdoor Unit Model Number (Condenser or Single Package) : RA1430AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : RH1T3617STAN 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 RUUD 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 : 28600 SEER: 15.00 EER (A2) - Single or High Stage (95F) : 12.50 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. Retinas that are _accompanied by WAS indicate an involuntary re -rate The new published rating is shown along with the previous (i.e. 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, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION 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. 132845012049075921 ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: