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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �II �rI771��-1 (ffrrat�s Permit Number: TIT. L 82� 11 r. ° 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: R-,(,Ga.rik(C�_ PROPOSED IMPROVEMENT LOCATION: Address:' S G2Cz 't� 'C A 3G e Z �)f ( 3 �S Property Tax lD#: :3Laa - &05-- OC)16,OpO-,q Lot No. Site Plan Name: Block No. Project Name: SQC e DETAILED DESCRIPTION OF WORK: Tr n e - A q14 0 2 3 — 7-M m 6-&4a m 5 a -ton - I q -5 Secr New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additio al work to be performed under this permit—check all that apply: Xechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Pond _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: / Cost of Construction: $ �7 i0� • OD Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name t D Sc�cc ' 2 Name:[ c Add re lc l0 Company: VV6 :5 r&In e- cityTeviSpti eadi Stater Address: cl014 5E /p-e Uty Zip Code: I —Fax: City: � State: Phone No. 7�O - 3�0^S�S� E- Zip Code: 3Ll c/ r y Fax: Mail: PhoneNo-77.1, a97-f.2oZ7 Fill in fee simple Title Holder on next page (if different E-Mail (99e16i O/7-7 from the Owner listed above) State or County Licen 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 ORTGAGE COMPANY: Not Applicable Name: Na Addre Addre City: State: City: State: Zip: h e Zip: hone: 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 grantin 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: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 alto to ommencin work or recording our Notice of Commencement. fJ,_ �) act, Signature of,Cont Contra or-or-Owner wilder as applicable STATE OF FLORI A COUNTY OF .Llact Sworn to(or affir d)prid subscribed before me of ✓Physical Presence or_Online Notarization this I' day of �29ZL by 6[+Iu c �Jo.e; yak Name of person maki g statemen . Persqiilly Known%ool OR Produced Identification Tyr=Identification Produced (S' ure of Notary Pu lic Stat o Florida) Notary Publio State of Florid Jennie L Knight mission No. (Seal), MyNN ie+elei on Exp. 10/5/2025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev CERTIFIED 0 Certificate of Product Ratings AHRI Certified Reference Number:204803772 Date:02-17-2022 Model Status:Active AHRI Type:RCU-A-CB(Split System:Air-Cooled Condensing Unit,Coil with Blower) Outdoor Unit Brand Name:RUNTRU Outdoor Unit Model Number (Condenser or Single Package):A4AC4023A1 Indoor Unit Brand Name:RUNTRU Indoor Unit Model Number(Evaporator and/or Air Handier):TMM5BOA24M21SAA 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,SO,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 RUNTRU 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&Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored,independent,third parry testing: Cooling Capacity(A2)-Single or High Stage(95F),btuh:23400 SEER:14.50 EER(A2)-Single or High Stage(95F):12.20 }"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 ar offering for sale. Ratings that ere eccomoanied by WAS indicate an inveluntery re-rate The new oubl'shed retina's shown alona with the ore " s(i.e.WASI rat a 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, personal and confidential reference. AlWCONDmONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory,org,click on"Verify Certificate"link vre awkc life be0er^ 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. —_-"---- - _-- - - ©2022Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 132ee59e99334e0770