HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:05-12-201(0 Permit Number:_
~
~Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ----Residential X
i
PERMIT APPLICATION FOR:To Select from dropbox,click here
RROR.PSEDINPR~VEMENT LOCATIGN:'
Address:0 DD (I'./
Legal Description:J"DdlQ n ',V,er E~.(es -Un"l~-DS -e,Ul-54 LDT 1(0 (N.AP 3'1 J I"NJ
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Back:Right Side:Left Side:_
o Windows/Doors
DRoof
Total Sq.Ft of Construction:__--,-..,,--_
Cost of Construction:$,373D ~
S'f.£!;of First Floor:
Utilities:USewer D Septic Building Height:_
Address:~~~c-=::~~.!.LC:~~..::.t::"--_
City:•e State:-f:C
Zip Code:.3Y05Z Fax:_
Phone No,(:I,d>4_1.L..5~-_'.:L"'_'flDlo~~8!-----
E-Mail:_
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
~"'-'--'-=7===--------State:&'
Zip Code:34q 2?Q.Fax:11ci-L{{eS-(jq~
Phone No,'712-4{05 -1(Pdt>
E-Mail:Oi1Va(rfnge.trrm.\"b~-hQf-onl\.com
State r County icense:CA1 tJ.to(ol/
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If value of construction is $2500 or more,a RECORDED Notice of Commencement'required.
,"~~pelE~E~!A~Cp~STRU¢rld~'IJ~r.qA\Y,!~H?J~M.ATI_9N:"~'/':r:'~"'~'~::/O";~~0~;"~,f';"'_>.c~;.,.~,",
.DESIGNER/ENGiNEER:_Not Applicable MORTGAGE COMPANY:_Not Applicable
Name:Name:_
Address:Address:-=-_
City:State:__City:--,-State:__
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 granting a permit will authorize the permit holder to build the subject structurewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,bylaws or and covenants that may restrict or prohibit suchstructure.Please 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,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 the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
FEE SIMPLE TITLE HOLDER:_Not Applicable
Name:_
Address:_
City:-,--_
Zip:Phone:_
The f!!.r~oing instrument was acknowled~efore me
this r l'+~day of HQ (~,20WaJ by.c:T »:».
(Name of person acknowledging)-
_Not ApplicableBONDINGCOMPANY:Name:_
Address:_
City:_
Zip:Phone:_
signature of Contractor/License Holder
~~~~~Fcf~ORI~~,,;{Luc;e.;
The for$;ing instrument was acknowledged before me
th~~day of ma~,2011101by
Uanu/e/T"))lIr/).//u-/
(Name of person acknowledging)"---
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(Signature of Nota;7b'-Statl>.~~t~~riH~J *"'Y~~....;::.~••••••V"/')'~
~~v .·\''i..l'IRES ".'?'~
Personally Known o~,,&~;"~elkntific .~~;..-..__
Type of Identification Produc$lul :5j :::•0,~~\J.-~~;--__~z :.~;r ~\f !u.,,:::
A.Q~•~.1-.::::Commission No,~·.v />(~.~::::-------~-;;;;,"'~-."1'4 ••v:>~.~<;~,,:~oo~~~..;,,~~..•~
Revised 07/15/2014
ZONING
REVIEW
SUPERVISOR PLANS
REVIEW REVIEW
DATE
RECEIVED
REVIEWS FRONT
COUNTER
DATE
COMPLETED
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
A.~~ICERTIFIED®
www.ahridirectory.org
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 Ratings
AHRI Certified Reference Number:7940891 Date:5/12/2016
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:RA1624AJ1
Indoor Unit Model Number:RH1T2417STAN
Manufacturer:RHEEM SALES COMPANY,INC.
Trnd~Brnndname:RHEEM;RUUD
Region:All (AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,10,IL,lA,IN,KS,KY,LA,MA,MD,ME,
MI,MN,MO,MS,MT,NC,NO,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SO,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.
Series name:
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 subjecHo verification of rating accuracy by AHRI-sponsored,independent,third
party testing:'',"}a
Cooling Capacity (Btuh):
EER Rating (Cooling):
SEER Rating (Cooling):
lEER Rating (Cooling):
24000
13.00
16.00
•Ratings followed by an asterisk (0)indicate a votuntary rerate of previously published data,unless accompanied with a WAS.which indicates an involuntary rerate.
AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
we ma ke Ii [e better"
CERTIFICATE NO.: