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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