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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �— Permit Number: Planning and DevelopmentSeMces Building Permit Application Budding and Code Regulation Division 1300 Virginia Avenue, fort Pierce FL 34981 Phone: (772) 462.1553 Fax: (772) 462.1578 Commercial PERMITAPPMATION FOR: Residential k TO Select from dropbox, click arrow at the end of line Address: Legal De: ED g YQ 1h W`� m In I LLVYJ n—"�_-- mrnorN � * S I LG GL -d J4Jt Property Tax ID #: Site Plan Name: a' Lot No. Project Name: Block No. _ Setbacks Front Back: Right Side: Left Side: l.v�QV\/tQ p�.L_i- ,A/c -{-U "' 3 -Mn 40 SeE R tt+r Co d,4,- AJI ncL'^cV ,-1-t 1o1 r+zV- n�oCi2l i-FcLr�L1L EP P W&d (Pi. i -i Lol"-k rl •'S ♦�.LIJ �Q-P.P�-,riCi HPQ+ MTar1.TA L -,I Gas Tank UGas Piping U_Shutters Electric 0—PlumbingS/Doors B aSprinklers Generator Total Sq. Ft of Construction: Roof SFt. of First Floor-. Cost of Construction: $ DO Utilitles: Sewer Septic Building Height: City: �-: . Zip Code: 1 I7 3.Fax: State: -- -_g Phone No. c) --iP�a � E -Mail: Fill in fee simple TIUe Holder on neM page (if different from the Owner listed above) or more, Name: '1Ut�� Company: Address-:rs City:.SllIr 6+ L -C.0 Zip Code: $�j Phone No. _!122 _ E -Mail: ae.. A... State or County License of Commencemn.r i...._..,__.. - �3w�slll h Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: ZIP: Phone: Not MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: _ Zip: Phone: BONDING COMPANY: _Not Applicable Address: City: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. wthichis In co Wic with any applicable lHome Owners tAssoclateionlr els, authorize y aws or anScuvenants that build ay restrictbor 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, wails, 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 recordina-vour Notice of Commencement_ _ Signature of Owner/ STATE OF COUNTYOF ORIDA �t S+, + LLL�I P� I COUNTY OF ORIDA�„/,� The forgoing instrument was acknowledged before me this, day of HT a 1-0 69,,-20 Ltl by The forgoing instrument was acknowledged before me this �day of (lo gra. 20 j_�o by —bnV I o & Y-JeR (Name of person acknowledging) tolgnacure or Notary Public -State of Florida I ZSgr(ature of Notary Public -State of Florida I Personally Known � OR Produced Identification _ Personally Known � OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. .i°`-"' LIN ARIE BOUCHAR Commission No. _. ✓• IgedN 1 : M\ I lune uaI lnuaen MY COMMISSION #FF125529 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 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: 7942204 Date: 10/3/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA16361 Indoor Unit Model Number: RF1T3624MTAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, Ml, MN, MO, MS, MT, NC, ND, 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 Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third parry testing: Cooling Capacity (Stuh): 36000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): ' Ratings blow N by an add (') indicate a volt re s e of previously pubfsn d para, operas acwmpani rd with a WAS, which moral an Inveluma ry rerale. DISCLAIMER AHRI does not endorse the protluct(s) listed on this Caf ificate and makes no representations, wamantles or guarantees as to, and assumes no responsibility for the products) listed on this Cerllflcate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s). or the nauthonmd alteration of data listed oa this CartlPcate. Cetlli ed ratings are valid only for models and configurations listed In the Sheri As www.ahrldirectorsorg. TERMS AND CONDITIONS MIs Certificate and Its contents are proprietary products of AHRI. This CetlRlcale shall only be used for Individual, personal and confidential reference purposes The contents of this Certificate may not, in whole or in pad, be depressed: copied; disseminated entered Into a compater database; or otherwise officer, in any farm or manner or by any means, except for the user. halkeEual, PJM personal arm confidemlM reference. AIRCONDMONING,Hu NG, CERTIFICATE VERIFICATION A REMIGERARGN lksnRRE The Information for the model cNed on that certificate can be verified at www.ahrldlrectory.org, click on -Verify Certificater link and enter the AHRI Combed Reference Number and the date on which the certificate wmake ]if, better^ as issued, .e which is listed above, and the Certificate No., which is listed M bottom right. - ©2074 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1311998186580161