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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:05/3d ZOllo Permit Number:_
•I
_..--_s ....~..-&i:J,'-"~,."_~".'....~•..~
,..'..._'_.._'_0'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 ......,.,p.X:....-__
PERMIT APPLICATION FOR:To Select from dropbox,click here
Address:.J..L]2aJo A 1=6~(a~()..lJ.e.....,.t _
Legal Description:_
Property Tax ID #:_B':f!Y-50\-I'tO \...ODD ~9 __________~LotNo.----
Block No._Site Plan Name:_
Project Name:_
Setbacks Front._Back:Right Side:Left Side:_
Shutters
D Generator
o Windows/Doors
DRoof
Total Sq.Ft of Construction:_
'£2 •....bOCostofConstruction:$_~-,-"",,~D,,--_
SCf.£!;of First Floor:
Utilities:USewer DSeptic Building Height:_
~!..!....!.-':;:~~AIo<::1"""""-State:n,
DESIGNER/ENGINEER:_Not Applicable MORTGAGE COMPANY:_Not Applicable
Name:Name:_
Address:Address:--::-:----:-_
City:State:__City:--::-:-State:__
Zip:Phone:Zip:Phone:_
_Not ApplicableFEESIMPLETITLEHOLDER:_Not ApplicableName:_
Address:_
City:~:_:__------------Zip:Phone:_
BONDING COMPANY:
Name:_
Address:_
City:----:_
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 str!JcturewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,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
cornmencina work or recording your Notice of Commencement.
Llsignature of Contractor/License Holder
~~'1T~~F ciiORlrlt;~1 Lc;e;
The for~q!.ng instrKIent was acknowled~efore me
this ~ay of ~.'20Wd by
Daml/el T ...))Uf-htl/if
The.forlYing instftT?was acknowledged before me
this 3~day of ~e ,2000 by
Gl1wel Tc ))111'110/4/
(Name of person acknowledging)---(Name of person acknowledging)"---
/..A :;f?a~A !'...\\\\111111//1"./1'11j"\\\IIlI/l/tHlllJ:£___~':J.d..r§{''p,-;(,~
(Signature of Notary '"~~~~Fr~~.~o ~~\/.\Y~-:r;;-,'~"u,...~
Personally Known -:~Pr~~t1~!lcation _
Type of Identificatio~~~d ~§i~:~:E
.~A:-••'??~Ui $..--fJJ§~'-(4-<\~''"'Commission No.~~'"~~";}I)~~~
'/1111//NOi"'?-.~\\\'~
Revised 07/15/2014
DATE
RECEIVED
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETED
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:1076061 Date:5/31/2016
Product:Year-Round Single-Package Air-Conditioner,Air-Cooled
Model Number:RSPM-A036JK
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,MO,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:RHEEM RSPM SERIES
Manufacturer responsible for the rating of this system comblnatlon is RHEEM SALES COMPANY,INC ..t -'~"
!':<,':1_',;".'/:;._'..ih.>:;:,,'IRatedasfollowsinaccordancewithAHRIStandard2.~0/240~2008for Unitary Air-Conditioning clndAir-Source
Heat Pump Equipment andsubject to verification ofrating accuracy by AHRI-sponsored,indep~ndentj thirdpartytesting::.'_~-.c _-•<C"-f'~.
,--''''.
Cooling Capacity (Btuh):
EER Hating (Cooling):
SEER Rating (Cooling):
lEER Rating (Cooling):
36200
12.20
14.00
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.""i er+r+s--:=.-'..
©2014 Air-Conditioning,Heating.and Refrigeration Institute liCERTIFICATE NO.:
AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
we make lite better=
131091902842985296
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:05/.31,1ZOllo Permit Number:_
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 -,.F-y:......---
11IIIII_~_-;7.,._',-__'-.'."..'.,....,~.-"Building Permit Application
Legal Description:_
Property Tax ID #:_700 Qd~Od.8357{7MJi ble'jJlQP-~-::4'i:I'-)-+--.\:;Lot No.._
Site Plan Name:Block No._
Project Name:_
Setbacks Front _Back:Right Side:Left Side:_
Shutters
D Generator
o Windows/Doors
DRoof
Total Sq.Ft of Construction:_
I f:z."QOCostofConstruction:$:-r-..;uD -~==~-----
S~of First Floor:
Utilities:USewer D Septic Building Height:_
Name~~~~~~~~~-------
DESIGNER ENGINEER:
Name:---,,--_
Address:----
City:State:
Zip:Phone:_
MORTGAGE COMPANY:Name:_
Address:::--_
City:--,-State:
Zip:Phone:_
___Not ApplicableFEESIMPLETITLEHOLDER:Not ApplicableName:_
Address:_
City:--:-;_
Zip:Phone:_
BONDING COMPANY:Name:_
Address:_
City:._
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 BuildingCodes and St.LucieCounty 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 work or recordin our Notice of Commencement.
I ature of Owner!Agent!Lessee
STATE OF FlORlll1A (/~~j.[',,/1,'-\
COUNTY OF ~/D uae»
Signature of Contractor/License Holder
~~~~~Fci~ORI~~t;1 &{Ct;~
The for~<ing instri\lent was acknowled~efore me
this ~ay of ~,20l.!Ja by
Dflml/ei T .2:J.1Ir htl/J{
The forlYing inst~was acknowledged before me
this 3~day of c '20~by
Gml/e!'y,'
(Name of person acknowledging)
\\11111111
(ignature of Nota;7ub'-StatB...'O ri!t<J)*.{~.~...••••••V'/>'/'§.;9 "S'l-I'IRE8 ".v@
Personally Known o~&~~~Mkntifici\t~
Type of Identification Produc~L.U:¥j:::,~'i~\5~
;::2:~~•{I:.€~~LU-'
:~~Q ~~§~§:'I--.~Commission No..~'.~./"(~~IIl...~g~.'4 t-0'~~••••~~.o,,~~
~•••••••••Io,.V~
Revised 07/15/2014
REVIEWS MANGROVE
REVIEW
DATE
RECEIVED
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETED
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:1076061 Date:5/31/2016
Product:Year-Round Single-Package Air-Conditioner,Air-Cooled
Model Number:RSPM-A036JK
Manufacturer:RHEEM SALES COMPANY,INC.
Trade/Brand name: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:RHEEM RSPM SERIES
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-Conditio,"!ing and Air-Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third
party testing:.~~':'
!
-If';_
Cooling Capacity (Btuh):
EER Rating (Cooling):
SEER Rating (Cooling):
lEER Rating (Cooling):.
36200
12.20
14.00
,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 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.f3'1<c;c-~-,-~-
©2014 Air-Conditioning,Heating,and Refrigeration Institute I CERTIFICATE NO.:,
AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
we make life better"
131091902842985296