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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-10-22All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. i Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: NV A e `�� cm PROPOSED IMPROVEMENT LOCATION: Address: IC2 1 Cl cles t d,�� PoY`• LUCID( Property Tax ID #: 1 9 LN t -- 0 Site Plan Name: 10 37_�$' AJ i /Z o cF SE 1l LI uu New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply. Lot No. F' 7 X Mechanical _ Gas Tank — Gas Piping — Shutters — Windows/Doors Pond — Efectric ` Plumbing ` Sprinklers _ Generator Roof -.- Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ -5-3 QZ . Utilities: — Sewer — Septic Building Height: OWNER/LESSEE: Name a r r Address: Q adnojiTal City: PQ f"t a- ( U Cj e State: -19L Zip Code: q Fax: Phone No. 772 3O) - ZSaS E- Mail.. Y on mmohnlyrYl at COfY1 Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Name: 1( C'_rf Sl nmo _ Company: Jy} A Address: i3TLI /QW Comnin�cr Centre City: Po v' - Lucie- State: F1 Zip Code: �� Fax: Phone No 772 3(-rQ T d 7qQ E-Mail Q e a C pJ 0 1 Ca W1 State or County License q 3 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: DESIGN[ Name: _ Address: City: — ENGINEER: Not Applicable Zip: Phone FEE SIMPLE TITLE HOLDER: Name, Address: City: Zip: Phone: State: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: — city: State: Zip: Phone: BONDING COMPANY: Name; _ Address: City: Zip; Phone: —Not Applicable 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 fallowing 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 com mencing work or recording our Notice of Commencement. Signature of Contractor - or - Owner Builder as applicable STATE OF FLORIDA L . �*` u C, C COUNTY OF Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization this /Z day of Van (4__, 2022- by e(t C�t0S1MO Name of person ng statement, Personally Known __X OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida) Commission No, f`fNa4Z (Seal) REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED y�W Notary PuaiiC State of Florida Brianna V Lorenz . My Cornmiasiort HH 042089 a Expires 0411412024 ZONING I PLANS S OR VEGETATION S LEMVEREVIEW REVIVW WREV REVIEW REVIEW Eligible for Federal Tax Credit n .YNYkkY,k'NW.AYF £: M.Y0.n. .5 'y:Rtit 1YaMi�`3Y9325x,CiGTRri�NNkn�'wp2Y02h1:WkY+kiYtivAtPf:�iPri."F'NPYF�tl1.S."NA'tSM4.0 .:�.T1kY!:Ss%imL�tiM1Y�MX Mwbrn.kea�, neie..vwxe.,�m.a.««. �.,....,...._ AHRI Certified Reference Number: 201294083 Date: 01-10-2022 Model Status: Active Old AHRI Reference Number: 7943535 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) : RA1648AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler); RH 1 T4821 STAN 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, INC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, Rf, 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 2101240 - 2017 with Addendum 1, Performance Rating of Unitary Air -Conditioning & Ai -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 : 44500 SEER: 16.OD EER 02) - Single or High Stage (95F) : 13.00 t"Active" Modal 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 cr offering for sale, DISCLAIMER AHRI does not endorse the product(s) fisted on this Certificate and makes no representations, warrantles 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 fisted In the directory at www.ahrid!rectory.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; dissominated; 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. CERTIFICATE VERIFICATION AIR-CONDITIONING, HEATING, The Information for the model cited on this certificate can be verified at www,nhridirectory, 0rg, click on "Verify Certif€sate" link & REFRIGERATION INSTITUTE and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life betlery which is listed above, and the Certificate No., which Is listed at bottom right, ©2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFI(-, Tl= kin • 13281,3041009071247