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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: ' To Select from dropbox, click arrow at the end of line Address: 5DA 09 2)UdA O nc:u-> Dr \ v -e_ , }-6%__T f'12Y c , p .5 zi`r Legal Description::V4-AWAY-) VNWe-t- _- IIYil j ;��71� Property Tax ID #: 0�;I'"C)tc�rl -C)co - 9 Site Plan Name: Project Name: --Ra t f) f'1" l l Setbacks Front Back: Right Side: Left Side: 2.0 1cz e_Q C -1 c l I r i� 1 • � I) P, I (- � / ! . � ��`o i 1 HVAC 11 Electric L_J Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 45t5ID A DQ Lot No. Block No. i (p 5F_e-r2 CL; rt �.15- ►-�. Y9 vvinciowsiuoors Roof 5 Ft. of First Floor: utilities:[]Sewer F lSeptic Building Height: Name W1 �\k Address: vo Y)ny_ City: _S+i )a r -�- State: Zip Code: 5` q,5_ Fax: Phone No. n) TR - a So - 00 3:a> E -Mail: Fill in fee simple Title (Holder on next page (if different from the Owner listed above) Name: _5yxVt 0 )P)► YA. -'r Company:A- ori !-- Address:101� 6A 15) ctl/YN U`« City: PV �T 6+ LUC e 12... State: t=C– Zip Code: -��IS� Fax: Phone No. E -Mail: State or County License: C- 19 ( 7& If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable State: Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. Not Applicable State: Not Applicable St. Lucie County makes no representation that is granting a permit will authorize thepermit 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 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 commencin r recordiPg4our Notice of Commencement S _ Signature of Owner/ Lessee/Agent Signature of ontractor/License Holder STATE OF FLORIDA COUNTY OF ?arT �SV . b.t&LIP, The forgoing instrument was acknowledged before me this _2a day of 1'y^16L1J_ 20 I1by i 13 P-) I Y-I�--C�-i(^ (Name of person acknowledging) In (Signature of Notary Public- State of Florida ) STATE OF FLORIDA COUNTY OF �4 r_� �-� t C�•A The forgoing instrument was acknowledged before me this day of , 20 W by DQ u t o E) i ► elf' (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known X OR Produced Identification Personally Known _ OR Produced Identification _ Type of Identification Produced Type of Identifk ad ill f i,u. vu, u LINDA MARIE BOUCHARD Commission No. !�+° LIl`�@ARIEBOUCHARE, Commission No. MYCOMMIS4&ft�FF125526 r MY COMMISSION! #FF12552& � � .,'.:',+���c!!;;•= EXPIRES May 21, 2018 t� F EXPIRF,S Allam 7t 9n1 o fa0 �is� FloridallotarvSertice.cpin (40 )398 0153 Floridallotaryservice.com Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I- S - I -On o This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service www.ahridirectory.org between Feb 17, 2009 and Dec 31, 2016. Certificate of FrOw-duct Ratiffinon AHRI Certified Reference Number: 7940565 Date. 5/18/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1618AJ1 Indoor Unit Model Number: RH1T2417STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: All (AK, AL, AR, Az, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, Rl, SC, SD, 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 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): 18000 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, 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 liability for damages of any kind arising out of the use or performance unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the of the product(s), or the directory at www.abridirectory.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; PM 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,ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make ]ile E.ecrer� which is listed above, and the Certificate No., which is listed at bottom right. — -- ©2014 Air Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: �. _ 131080774264888685