HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:0(0/0 6hz 0 1(0 Permit Number:_------
I I-..--'.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 Y
loT 23
Lot No.23
Block No.4 ;;;)Site Plan Name:_
Project Name:_
Setbacks Front._Back:Right Side:Left Side:_
o Windows/Doors
DRoof
Total Sq.Ft of Construction:__-=-_
Cost of Construction:$J::±-=2D)===--~_a _
S~of First Floor:
Utilities:USewer DSeptic Building Height:_
Name:uel \.r
Company:~"o.nt..~A-Ic.of +he.-\reaSLltt-
Address:~S.l'vVirfAC+Avenue.-
City:Fey+terce.State:PL
Zip Code:34q ~2-Fax:112-%5~4S-
Phone No.tJ 1l-4{o6 -I(oOv,
E-Mail:a.d\lan+~tyl/.I ..5€hohnai\.com
Sta or County'License:~03CH.oCoL/."*''7
---'--><-;:......:....----'-~~=---State:~L
If value of construction is $2500 or more,a RECORDED Notice of Commencemen is required.
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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 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 coun~makes no representation that is granting a permit will authorize the germ it holder to build the subject structurewhichisinconllctwithanyapplicableHomeOwnersAssociationrules,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
comrnencinz work or recording your Notice of Commencement.
IVI<~//;J r.IVJ~~7~~"""-r,'\
r Si'gr(ature of Owner/Agent/Lessee signature of Contractor/License Holder
STATE OF FLORlt~d LU(!f~STATE OF FLORIDA ~"1 Luc;e;COUNTY OF o COUNTY OF '<;Otln·
The for~ng instr~ent was aCknowledilletore me The fo~oing inst~ment was acknowledged before methis::ti!:.?day of •••••....~,20 I by thiS day of LUle....201J1e]by
0f1fnl/e!T ~ilrhll/)(GlJ1t!eI -c hurho.-u
(Name of person acknowledging)"-(Name of person acknowledging)<,
/P.a-t\lIlIlI/'Jf/~11 -:~aLAj_'.,J •••Ir;t~.,_~,1\1\1""111",
(Signature of Notary~~~q§f Fr&~(Signature of Nota7-5tat~$~~i!t9.l ••~·'%~
~C)~{J'e·.\Y~~~,··,.;'l-I'IRES <••00PersonallyKnown0....f~'Profj~d,~i=ication Personally Known oR§>,,&~;'Mlkntifici\i~
Type of Identificatio~~~d 4"s i~:'~§f ---Type of Identification Produccilhu if!!~,,0,%~'5~..~~\'0 ~~1..-0~=~:~~.~~~:UJ~~'-i;;-"~::'d:~Q ~I <::)'£§_I-::::Commission No.~k ".~,~.'~)Commission No..~••D-t.7>(~'\tt$.:~~:;.~••••••••••«\3 i$f-'~-••'#-KO~f>O·~;$'/1111/1*N011\?:.1,\\\X'~.........~;..~~~
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Revised 07/15/2014 IIIIIIIH\II\\\'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVECOUNTERREVIEWREVIEWREVIEWREVIEWREVIEWREVIEW
DATE
RECEIVED
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:7942208 Date:6/8/2016
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:RA1636AJ1
Indoor Unit Model Number:RH1T3621MTAN
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
HeatPump Equipment and subject to verification of rating accuracy by AHRI-sponsored,Independent;third
party testing:-'
Cooling Capacity (Btuh):
EER Rating (Cooling):
SEER Rating (Cooling):
lEER Rating (Cooling):
36000
13;00
16.00
•Ratings followed by an asterisk (')indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate.
AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
we make life better"
CERTIFICATE NO.: