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HomeMy WebLinkAboutSUBMITTED PAPERSBuflding Permit Application Pidnninganti Development S&vicL6s BVilding: and Code ReguI6 tion Division 2300 Virginia Avenue, FortTlerce. FL 34982 Phone- (772) 462-4553 Fax- (772.) 462-1$78 Commercial. Residential'. PERMIT APPLICATION: FOR--. Address: Legal Description: � i E Property Tak,lD#'. Lot No: Site Plan Name:. Block No. Project Name: 1� Setbacks. :Frqqt­ Rqq�-. Right.Sid.e..: Left. Side:. wiponaivorKlOpepe7orrnea -un.ae.r.tnis;perm.ii—cneCKaiitnatapply:' V—/MechahicAl —.66s Tank Gas,:Piping —.Shutters Windows/Doors _.Electric. .— Plumbing —Sprinklers — Generator Roof Total Sq..Ft of Construction: Sq. Ft. of First Floor: Cost of Construction::$ Utilities: _Sewer _Septic Building Height: Address: City:, State: Zip Code: Fa * x: , Phone No..(771 .EWaik. Fill 10 fee simple Title:.Hblder on. "ext:pcigq:( If different. from I the OWn6r listed above) If valtie of.coriArtictiOn it 2500 or more, a RECORDED Nd.tide of Name: C-0 I Company: Address'. N)l Zip Code-. �L4QIRLV Phone Nolc-7-16�1) 5 :E-Maik . i +04ac- State or County License: CornmL-nceffidnt is: 11 state: rL Fax -'5 LLI., DESIGNER/ENGINEER: ✓Not Applicable: Name: Address:. City: State:. Zip: Phoney FEE SIMPLE TITLE HOLDER: J Not Applicable Name: Address: City: Zip: _.. Phone:.... MORTGAGE: COMPANY: ✓ Not Applicable Name: Address: City:.State: Zip: Phone: BONDINGCOMPANY _/ Not Applicable Name: Address:. City: Zip Phone: OWNER/ CONTRACTOR AFFIDVITApplication: is hereby made to obtain a permit to do the: work. and installation as indicated. certify that no work or: installation has commenced prior to the,issuance ofa: permit: St. Lucie County makes no representation that is granting a.permit will authorize the ermit holder to build; the subject structure which is in conflict with any ame O pplicable Howners Association rules, bylaws or anscovenants that may restrict prohibit such structure. Please consult with your Home Owners:iAssociation and'.revieW your deed for any restrictions which may apply. In Consideration of ttie granting of this requested:Pe.rmit,.l do hereby agree'that I..will, in all respects, p&form.the'work in, accordance: with the approved plans, the Florida; BuildingCodes: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 o another non-residential use WARNING TO OWNER: -Your failure.to Record a Notice of Commencement may result in your'paying.twice: for improvements to.your property AN oti.ce of Commencement must be recorded and posted on the j6bsite before:ahe first inspection. If you intend to. obtain financing,.consult:with lender or an attorney before commencing:workor recording.vour Notice of Commencement. Signature bfOwnerl. Agent/ Lessee Signature of Co or/license Holder. STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _ 12-�- COUNTY OF The forgoing instrument was acknowledged;. before me 1 The forg ing instrument was acknowledged before me thi<�` Iay.of gab?mlpQY 20 by : this, ay: of 20(4. by ra \ L (Name of pers acknowledging:) (Name of perso cknowledging ) i. (Signature of Notary' -Public -`State o Florida.) (Signature of'Notary Public- St to of Florida ). Personally Known. .✓ ok Producedadentification:. Personally. Known: ✓ OR:Produced Identification Type of Identification Produced of Identification. Produced:. : 10Y t& No ry Public State of Florid Coniniission No. °� 1:(Sg orah Russell Co mission No. My Commission EE038992 u �o+� �rtplres 1110512914 Caro 0, N. Notary Public State of FI = �, ^ Deborah Russell ' 9lFOfF��� E fires 11/05/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS. VEGETATION S. COUNTER. REVIEW REVIEW. REVIEW REVIEW REVIEW REVIEW DATE' RECEIVED DATE .COMPLETED.: . Kev: /./1u14 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. Certificate of Product Ratings AHRI Certified Reference Number: 1076069 Date: 9/30/2014 Product: Year -Round Single -Package Air -Conditioner, Air -Cooled Model Number: RSPM A048JK Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Series name: RHEEM RSPM SERIES Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC. Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate 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 Ilability 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. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information forthe model cited on this certificate can be verified at www.ahridfrectory.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 ' 13056557759265�a3, ©2014 Air -Conditioning, Heating, and Refrigeration Institute�Z1F��1-E N�yE