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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INF MU5T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; � � �,�
Permit Number:
s:
Burldin.e Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
Legal Description:
Property Tax I D #�
Site P#an Name:
Project Name:
Setbacks Frort_ Rack: Right Side; Left Side;
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
&HVAC
wor to e e Orme un ert is permpp y: Gas Tank ❑Gas Piping _ Shutters
Electric 0 Plumbing Sprinklers 11 Generator
Total Sq. Ft of Construction;
SQI�FY�.I of First Floor: _
Cost of Construction: $ O� ; (i Utilities: u Sewer Setfe
OWNER/LESSEE;
Name 1 6
Addr '
City: )r—
,� � state:
Zip Code Fax:
Phone No, —
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR;
Name. �•
Company If -C ; Ck
Addr s
City:
ZipC oce:+ U,
on No, --
E-Mail:
State or County Licenser,_ -
If value of construction is $2300 or more, a RECORDED notice of Commencement is required.
C(
Lot No,
Block No.
-C .
Windows/Doors
Roof
Building Height;
Stater
_ Fax:
1 SUPPLEMENTAL CONSTRUCTIQ i,�,IEN LAVA INFORMA -1 'N
INEER: Not
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
____ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
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 Borne 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before tbe first inspection. If you intend to obtain financing, consul n attorney before
co enci rc or record I u Notice of Commencem
_ Signature of owner/ Lessee/Agent
m C"
STATE OF FLORIDA
X
COUNTY OF . L t
� ao
The forgoing instr nt was acknowledged before
m „u
The forgoing ins ent was acknowledged before
n� 9
this (S day o 1 20I 1k by
Ld;
S � �l � i F 1L
E
.�N1f1iNJJi.
(Name,pf person acknowledging)
re of Notary Public- State of Florida )
Personaily Known 1-'_�_ OR Produced Identification
Type of Identification Produced
Commission No.E 7 (Seal)
Revised 07/15/2014
Signature of Contin' etor/License
STATE OF FLORA
3 j'
COUNTY OF
SUPERVISOR
PLANS
VEGETATION
The forgoing instr nt was acknowledged before
m „u
this day of rrt 20 lip by
, V a
REVIEW
n o
Don—'� ` i -ma
C_2�
(Name ofd rson acknowledging)
REVIEW
DATE
1+111H)IJj
( ignature of N tary Public- State of Florida)
a�llla+`,
Personally Known L -------OR Produced Identification
Type of Identification Produced
Commission No, ti '7 -%- (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Retinas
AHRI Certified Reference Number: 7493633 Date: 3/1/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: RA1430AJ1
Indoor Unit Model Number: RBHP-21
Manufacturer: RHEEM SALES COMPANY, INC.
Trade/Brand name: RHEEM; RUUD
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.
Series name:
Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC.
Rated as follows in accordance with AHRI Standard 2101240-2008 for Unitary Air -Conditioning and Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 29800
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 16.00'
IEER Rating (Cooling):
' Ratings followed by an asterisk(*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, whichindicates 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 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.
AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION
& REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ah rid rectory_org, click on "Verify Certificate" link
ive make Life i eLrer"
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,
©2014 Air -Conditioning, Heating, and Refrigeration Institute EC RTIFICATE NO..
1 31 41 34093321 23 7 80