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1609-0196
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED Date:? z l Permit Number: � w ildin PIe ° Planning and DevelopmentServices b IOil Mmilication Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1.553 Fax: (772) 462-1575 Commercial PERMIT APPLICATION --------- Residential N # To Select from dropbox, click arrow at the end of line Address: LL -IC -0-1 CC) Legal Description:_k 00', i Property Tax 1D ##: - LJ Site Plan Name: Project Name: Setbacks Front-- Back _ . Right Side: __ ^t Side. Lef I`llr�0ATl A)Ar t->/©(!� ;v SE e rz t4 i's-- ( 4 1�3 i`i Cc �F t ��'� R iJ 15+45 3 1 eti A w sem}rF Ld/ (D r_UJ :. U;trona wor to a 9e orme un er t is permrt - c ec . F HVAC appy: . �j _has Tank []Gas Piping ` Shutters Electric � windows/Doors Plumbing Sprinklers Tota! 5q. Ft of Construction: � Generator � Roof Cast of Construction: $ � S . Ft. of First Floor: Utilities: Sewer oSeptic Building Height: Lot No. Block No. Name i. '.i 6111-1� Address: [�, City: p ('Y� f' dLLL-L —Co Zip Code: Fax: State: F �.—�� Phone No. E -Mail: ^� Name: 1] i e r Company: • �\1ICS Address: �� �� City: i 0YT �cjL 'State: Zip Code: Fax: F71 in fee simple Titfe kialder on next page (if different Phone No. % -- f r ! LoC] from the Owner [fisted above) E-Maif: /4-'C� �p 1`v26 Wo State or County License: t��, 19 J ��,�� if value of construction is X2500 or more, a RECORDED Notice of Commencement isrequired. 1( km NEER: — Not Applicable Name: Address: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Not Applicable Name: _ Add ress: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City. Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. Not Applicable State: Not Applicable 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 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 r record i ur Notice of Commencement-- - ommencements- - _ Signature of Owner/ Lessee/Agent Signature re STATE OF FLORIDA ,STATE OF FLORIDA oY, - } r COUNTY OF �+ir ��' ;l COUNTY OF L�t� The forgoing instrument was acknowledged before me this J2_ day of a 20 by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) CJ The forgoing instrument was ziccknowledged before me this 19day of . 20 i?by (Name of person acknowledging } �( Ig iture of Notary Public- State of Florida) Personally Known OR Produced Identification Personally Known l--� OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. ''''"Y' LIN ARAE BOUCHARC Commission No. NDA MAI�PE9�3uCHAR4t]. '€ My COMMISSION #FF125526 F LC ? .MY COMMISSION #FF125526 Revised 07/15/2014 i EL 3sg'a1s3 (A67) 3980153 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 5 Ton SLI n;re-r" This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. AHRI Certified Reference Number: 7512254 Date: 9/12/2016 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: RP1560AJ1 Indoor Unit Model Number: RHIT6024STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD 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 (fituh): 58000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15,00 Heating Capacity(Btuh) @ 47 F: 56000 . Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) @ 17 F: 35600 *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, 'AM personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at wwsrr.ahrid Irectory.org, click on "Verify Certificate" link we make life better - 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. - ` -- ©2014 Air -Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 131181787920866578 This combination qualifies for a f=ederal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. AHRI Certified Reference Number: 7512187 date: 9/12/2016 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: RP1548AJ1 Indoor Unit Model Number: RH1T4821STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD 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 Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 47000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 Heating Capacity(Btuh) @ 47 F: 44500 Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) @ 17 F: 28800 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 assunnes 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 whale 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. Alts-CONtrMONINC, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information fpr the model cited on this certificate can be verified at r ww-ahridIrectory.org, click on "Verify Certificate' link we make lite better - 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. OO 2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131181788703221623