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HomeMy WebLinkAboutBuilding Permit Application Rug 17 16 08:25a Treasure Coast Ae1C 7723359121 p.2 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECE!"VEE Building Permit Application AUG t 7 2016 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: bov-e 6fol Legal i i Descrptcim.b(`u.c,jj (.'jU_b (0(brlu� 11 BOCA 13, 4p'- /bl Property Tax ID#: J- 0 10 0L (D 0 Of, Lot No. F _ Site Plan Name: Block No. ProjectName:.. SoAC,6 ej wAp 0 h VZ Setbacks Front Back: Right Side: �Left Side: DETAILED DESCRIPTION OF WORK: Ltvie- 4- CONSTRUCTION INFORMATION: Additional work tobe ertormed under this permit—check all apply: OHVAC Gas Tank E]Gas Piping Shutters E]Windows/Doors 11 Electric E-1 Plumbing []Sprinklers Generator Roof Total Sq.Ft of Construction: S Ft of First Floor: Cost of Construction:$ Utilities. Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Address: Company: City: State: FL Address- Zip Code: Fax: city. State: Phone No.'_'�"'o'- X. ^0 Zip Code: -'Iticif* Fax: E-Mail: Phone No. -17,z- I—Atz-1-jCj Fill in fee simple Title Holder on next page if different E-Mail: -'FIC,i6- 6, CLA i!L-{— from the Owner listed above) State or County License: Li)` �, If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Aug 17 16 08: 26a Treasure Coast A/C 7723359121 p. 3 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNERANGINEER: _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: 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 structure which is in conflict with any applicable Home Owners Association rules,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 1 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 our Notice of Commencement. _ Signature-of Owner/Lessee/Agent Signatu[e ofsontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ", A 4�y COUNTY OF irk; lr�� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this���day of -A 6� 1r5� 20 /I-;by this�_day of %�=C✓i(r,= ,20 _1L by (Name of person acknowledging) (Name of person acknowledging) (Signature/of Notary Public-State of Florida} (Sign atu re`of)Notary Public-State of Florida) Personally Known i" OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced �+. �'"r�'ti`- .(CMIp ADAMS Commission No. ,::a' JQd'eg�t4DAMS Commission No. :.• _ Comm1'ss o H FF 907740 �• ^� Commission 4 FF 907740 - •= i• •_ - - My Commission Expires 's; _ My Commission Expires �s�'+. eta yam•,r.�.` IeF;EIGFV 1 4. 201 •nuOry a.� Revised 07/15/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Aug 17 16 08: 26a Treasure Coast A/C 7723359121 p. 4 w ' i AHRI Certified Reference Number: 7493626 Date: 1217/2015 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number: RA1424AJ1 Indoor Unit Model Number:RBHP-17 Manufacturer.RHEEM SALES COMPANY,INC, Trade/Brand name: RHEEM;RUUD Region:Southeast and North(AL,AR,DC,DE, FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,TX,VA AK,CO,CT, ID, IL,IA, IN,KS,MA,ME,MI,MN,MO, MT,ND,NE,NH,NJ, NY, OH,OR,PA,RI,SD,UT,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 2101240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(Btuh): 24000 EER Rating(Cooling): 12.50" SEER Rating(Cooling): 15.00* IEER Rating(Cooling): `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 di rectory atnv .._.,,..,,,.ecto:_'I. n _y 7-1 77.T. TERMS AND CONDITIONS r ' 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; '::' `:?.J •_ •`^: 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 .:;":.z'.ri;ii:ectory.erg,click on"VeW Ce;i;ic.9o"link we make tire berrer- 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. 130939807067685304 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: