HomeMy WebLinkAboutBuilding Permit Application·ALLAPPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:DB!I fa {20 I (P Permit Number:_
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 X
PERMIT APPLICATION FOR:To Select from dropbox,click here
Mdress:~bbD 6al+b=~~5~h~~~~D~e~_
Legal Description:lSl1\JClnOa.C1LLlo-PL.A=I-rt.0\::l -EU<.32 LDT ~(oe.,3'75Y -4'3)
Property Tax ID #:,3l}86 -'102 -DZ2l a -DDD -9 Lot NO._i._
Site Plan Name:Block No.32.
Project Name:_
Setbacks Front _Back:Right Side:Left Side:_
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A\c.C,h(toe,e OW)ll~e fn.lli\6ej QAC A ILl-all-CO;Y±oo,
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Shutters
D Generator
o Windows/Doors
DRoof
Total Sq.Ft of Construction:_
Cost of Construction:$_Lf...:..'l---:..;::D'-=D'-~_D _
SCf£!;of First Floor:
Utilities:USewer DSeptic Building Height:_
o.V\{NER/tE55EE:CONTRACTOR:
Name ~r\dOv f\r\-eDe:-t:{a.4\e...
Address:&DO 0ttl+bu &h W
City:4=bY'-\-Sf.Luu~
Zip Code:3L{t\'Sd-.Fax:-----:-------
Phone No.140 -l£1 D '7-23£>\f _
E-Mail:_
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State:FL
If value of construction is $2500 or more,a RECORDEDNotice of Commence
_Not ApplicableDESIGNERENGINEER:_Not Applicable MORTGAGE COMPANY:
Name:Name:_
Address:Address:_
City:State:City:-..,...State:
Zip:Phone:Zip:Phone:_
_Not ApplicableBONDINGCOMPANY:Name:_
Address:_
City:_
Zip:Phone:_
FEE SIMPLE TITLE HOLDER:_Not ApplicableName:_
Address:_
City:---;_
Zip:Phone:_
OWNERI 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 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 work or recordin our Notice of Commencement.
Signature of Contractor/License Holder
~1'GT~~F;:-ORI~~t/;1 luc:;e;
I ature of Owner!Agent!Lessee
STATE OF FlORI~~'f.['"dl'~ICOUNTYOF~~lIC utse-:
The for~ing instzr:;nt was acknowledged before me
this/b.L.:dayof %[.15+,2011(."lby
Grnf.ld .t r;.
The forgfling Instrument was aCknowled1L.kfefore me
this /gr'-dayof HU5=u~+,20 by
0lifni./e.!T 0.');-/r A,UK
(Name of person acknowledging )-(Name of person acknowledging)
Revised 07/15/2014
REVIEWS PLANS
REVIEW
DATE
RECEIVED
MANGROVE
REVIEW
FRONT
COUNTER
SEA TURTLE
REVIEW
ZONING
REVIEW
SUPERVISOR
REVIEW
VEGETATION
REVIEW
DATE
COMPLETED
A.~!!ICERTIFIED®
www.ahridirectory.org
Certificate of Product Ratings
AHRI Certified Reference Number:7493511 Date:8/16/2016
Product:Year-Round Single-Package Air-Conditioner,Air-Cooled
Model Number:RACA14048ACT***AA
Manufacturer:RHEEM SALES COMPANY,INC.
Trnd~Brnndname:RHEEM;RUUD
Region:
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-:Conditionil'lgand Air-Source
Heat ~umpEquipment and subject to verification ofrating accuracy by AHRI-spol1sored,irtd~pend.en~,thirdpartytesting:-.........C •••.••••
CooliD9 Capacity (Btuh):
EER Rating (Cooling):
S~ER Rating (Cooling):
lEER Rating (Cooling):
46000
11.70
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,
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AIR-CONDITIONING,HEATING,
&REFRIGERATION INSTITUTE
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