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HomeMy WebLinkAboutBuilding Permit ApplicationPlanning 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 ~---
ALL APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Qam /.;plitJ Permit Number:I I ---------
'"COUNTY "-......,.
FLOR.IDA --
Building Permit Application
Lot No.[3 ~I 4
Block No.q
Project Name:_
Setbacks Front _Back:Right Side:Left Side:_
ShuttersDGenerator
o Windows/DoorsoRoof
Total Sq.Ft of Construction:_
Cost of Construction:$3'350 ~
NameJdeJen Lucas
Address:820D AvenLle...~
City:~r.+:Ple(ce.
Zip Code:~Lf7 Fax:_
Phone No.11;l-4tdo_~lfO_"_;:;..;3~~~------
E-Mail:_
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
S'f£!;of First Floor:
Utilities:USewer DSeptic
StateR..
Building Height:_
I
Name:~~~~~~~~~~~~--~
Com pa ny:OO.\lt11:ttz:J~.-1iJ~~~~mill!lliU.iJtlSl
Address:~~""'-'--'-'-"-""""'-~~::::::">O"'lL...>=::....."..,~----
City:"f+,IUCe.,
Zip Code:3441:>2-Fax:,,2-4<o5-4l\tlS"
Phone No.-'l2-4(05-\took
E-Mail:ad van-l-t1~~~~@ bol rolL\.COot
Sta e or County License:•ottoloLi•-:tt:~.,.,')~.
If value of construction is $2500 or more,a RECORDED Notice of Commenceme is required.
'--'.,'C,"'''j,""L:O.'"",',<'~..~_,,,,'-_,;'_',::c ",--:'.:,,;.:,"~\_."!~~:'!~!&:/Yi'f~IL~,-_~_,o .,'rilt~~rpg~~~~JA~~;gONsT~~;qJQN;~~~N,l.bW~JO~M~Ilp~:-"};:;~,-"
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:
OWNER/CONTRACTOR AFFlDVIT: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 coun~makes no representation that is granting a permit will authorize the germ it holder to build the subject structurewhichisinconictwithanyapplicableHomeOwnersASSOCiationrules,bylaws or an 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.
IVl <~//.;JLA~IVJ;;~~7~~
'S'fgrfature of Owner/Agent!Lessee S'Ygn'atureof Contractor/License Holder
STATE OF FlORIt1u d LCttl~STATE OF FLORI~~'1 LuCJ:6COUNTYOF/I COUNTY OF Ot In
Th~ing inst~as aCknowled~efore me The ~ing instrument was acknowledged before me
this day of m~,20~bythidayof,20 I by
Da.mIJeI T »:»:Gmlld T,!Jurhou,
(Name of person acknowledging)-(Name of person acknowledging)<;
./P,.'''''''''".L~~(~ut.A J .,\\\\11111/1/11>"I .A>{r;!I/,,_
(Signature of Notary '"~~~f§f Froi~(Signature of Nota?-Stat~~~~~i!t~)••-:·'%~,.~0 ~\)'oe··\Y~~~"~'l-I'IRES <.,00PersonallyKnown-ftidi.'profj~q,~itication Personally Known o~#~~~efentifici\i~~~.~,,~,---Type of Identification;d ~~J~:.~:::Type of Identification ProducSLLI i~;;;:'!ff'l~'6i-2.2a •\2 $.~A.-••'0 ~~i/&;;"=§..~2 ~~~•~~1:}:!~~'-fit <'~Commission No.~'"~'!";}j)Commission No .::;.v;n ($,e%~:~~~••••••••'(\S~.~··.~4 ~~~..';~
'//111/1*NOT f>-\\\",'"~e..~o,!.o ~~
~.1 •••••••••~\.~~•••••~
-"111.,.'.vOTA~:,\~
Revised 07/15/2014 //1/111/1111\1\'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVECOUNTERREVIEWREVIEWREVIEWREVIEWREVIEWREVIEW
DATE
RECEIVED
DATE
COMPLETED
A.~!=!ICERTIFIED®
www.ahridirectory.org
Certificate of Product Ratings
AHRI Certified Reference Number:7940895 Date:5/24/2016
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:RA1624AJ1
Indoor Unit Model Number:RHAL-FR24P
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.
lEER Rating (Cooling):
o Ratings followed by an asterisk (0)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 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.
CERTIFICATE VERIFICATION
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,
which is listed above,and the Certificate No.,which is listed at bottom right.==c;;;;-.,..,.,.,=-:-=-=~-
©2014 Air-Conditioning,Heating,and Refrigeration Institute ;ifCERTIFICATE NO.:
AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
we make life better"