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Building Permit Application
ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _ 14 J - / (.lam Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential J< PERMIT APPLICATION FOR: Mechanical 0 PROPOSED IMPROVEMENT LOCATION: Ad dress: IBJ Legal Description: ca_nfUar V 1 I�C�S �ndd Property Tax ID #: .. Site Plan Name: Project Name: Setbacks Front 1��Back: Right Side-. Left Side: Lot No. Block No. DETAILED DESCRIPTION OF WORK: _JH A/c, Maig e- Dw'° A -)e8HPo?1,707,5#A - RA 1430 1 N 4 E-Yacl- Rep avecQ CONSTRUCTION INFORMATION: A�ditjpnal work toa er orme under this permit -check a apply: VAC 1, Gas Tank Bas Piping _ Shutters Q Windows/Doors EI Electric ElPlumbing Sprinklers 1:1 Generator 1:1 Roof Total Sq. Ft of Construction: Cost of Construction: $ 3200 on 5 Ft. of First Floor: _ Utilities:ll Sewer Septic Building Height: OWNER LESSEE: CONTRACTOR: Name Name: 's Address: Y Company:iIC. city :eiYg_ l State: FL Address: Jr S . 1 1* Tlr- Zip Code: 3r� Fa `~ City`State:L 4�_ Phone No. � � Zip Code: Fax: -7 - E -Mail: Phone No, Fill in fee simple Title Holder on next page if different E -Mail: I (LZ, from the Owner listed above) State or aunty License: 040A n r If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 wiii 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. Pi ea se consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, l do hereby agree that I will, in all respects, perform the work in accordance with the approved pians, 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, wails, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may resulf1myour paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. if you intend to obtain financing, consult with lender or an attorney before commenciniz work or recording; your Notice of Commencement. Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA p RR COUNTY OF IJ The forgoing instrVinent wal acknowledgeypefore me this I day of zo by 1 irk Vi ries (Na of person acknowledging) (Signature of Notary Public- Stat o Florida Personally Known. OR Produced identification Type of Identification Produ _ Commission No. Revised 07/15/2014 STATE OF FLORIDA COUNTY OF , The for Ding instrument was a knowiedged efore me this day of ri 20 by Mo-rk Vines (Name o person acknowledging) (Signaf ure of Notary Public- State &Iorld Personally Known OR Produced Identificati ITvne of Identification Pr x Public - state ofFlarld ommisslon No. [S d�lrii5miaelon#FFBs74,47 F-Xplres io•Sep•sa Notar ub c state el Florid CMAJ&n' #FF9i7447 Expires 10•S9p-s9 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Rb WI U LL.S Q� w w /� ❑yy L 4 u Q V) W J Cn Q U I� 2 LU W ¢ Z" z Q z U w U_ Q m H U_ 11.1 U Q Q SM, wandH39N 3'MMM crw-oc (M)1ni 0990 -He Wol'w ztrtrcc -u 'F4,Y3o O-13Idv33❑ Y&r, zznNSAY LOZI M5. 091 sNN4Go-;u add laNIuva .1=w OaiNnow JoOd t o0oc-I sc (oz C) :Hd I mu ZY 'Ruws ixoa ar Vd OOCNM37KJ MO 0095Ln �Ln N 0 r CL �zz� Luz lad i oo a io 11 g g d adq P � - . aH PdW fig oo�l Lu ARM MW� z_ ��W e i_r�I�P_ y LLI^i uHNosr�gWm w S} CL Q QQ Q oA Q rs'a e3xY ua 5s- TP J w d .. jw io t Lu w IL 0oo C F 0 r CL �zz� Luz pz«� ❑ a 2�ttt a a IIH .'' O a lit Z LU atCkn Lnt w U s� u z wia L) C a �r f� I3:� si_ 1 1 v �w si a ❑ � �� �� ���� M o� r .. w d .. jw io Lu w IL 0oo C 0 CL �zz� pz«� ❑ 2�ttt a a IIH lit o s� z wia L) i 4 au'awvdd lig aaodans .oz tit I �I3 �Im Flow 1 ERTlFIED ow w.ah rid i rectarv.urg This combination qualifies for a Federal Eneri Efficiency Tax Credit when placed in servil between Feb 17, 2009 and Dec 31, 201 Certificate of Product Ratings AHRI Certified Reference Number: 7493633 Date: 4/1/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1430AJI 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: _ Ma nufacturer.responsible for the rating of this system combination is RHEEM SALES COMPANY, INC. i H d RateA as follows in` accordance with AHRI�Standard`2101240-2008 for -Unitary Air -Conditioning apd Air -Source Heat Pump Egtxipmentatndobject to verification bf rating accuracy by AHRi•spohsored, lndepandent,,third party testing: -- - , Cooling Capacity (Btuh): 29844 -' •, = x EER Rating (Coaling): 13.00 SEER Rating (Coaling): 16.00* � µ" IEER Rating (Coaling): • Raunp lonowed by an asterisk I') indlcata a voluntary rerate of previously published data, unless accompanied with a WAS, which Indicates an Involuntary rerote. DISCLAIMER AHRI does not endorse the products) listed on this Cerdficato and males no representatiarrs, werra noes or guarantees as to, and assumes no raspansibllity for. the product(s) listed on this C wtttkais. AHRI wpressty disclaims ort liabMty for damages of any kind ariaing out of the use ar performance of the prcduct(s), or tha unauthorized alteration of data listed on this Cartiftcate. CoMflod ratings era valid onty for models and configurations listed In the directory at www.aItrldIractary.erg. TERMS AND CDNDITIONS This Cartiflcata and Its contents arc praprlstary praducts of AHRI. This CarOcate shag anly be used for Individual, personal end oonfufantiaI referance purposos. The contents of this Certificate may not. In whole or In part, be reproduced; ccplad; dissemin.led; 90M entered Into a computer database; or otherwise uUlt;ad, In any form or manner or by any means, except for tha users Indhldual, pamndl and ednf eentlal 19folenco. AIR-WNQITIQNI lar HF�9TIttp, CERTIFICATE VERIFICATION A REFAISERATIon INSTITUTE The Infermatlen for the mad et elted on this certlflceto can be vertfled at www.ahrldlrecta ry.arg, Opckan •Varity Cartirlcata- link we make lde better - and en tar tha AHRI Cortlfiod Rafe rence Number and the date on wltich the contmeata was issued, whlch Is listed above, and tit c Certlfteeta No., which Is listed et bottom right. ©207.4 Air -Conditioning, Heating, and Refrigefatlon Institute CERTIFICATE NO.: 13i°4°°2�a6i$'g�