Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date: i /VI lA(JQ Permit Number:
Ir
•
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 Commer ial Residential
PERMIT APPLICATION FOR: To Select from dropbo�, click arrow at the end of line
Address:/ of 11 'l "V -,\d
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
Back: _ Right Side: Left Side:
L4
DETAILED DESCRIPTION OF WORK:
C)-C.OX- L+ ri sp►14-5_�5-
i q_s-e e r 12 l4t.n- ems' -
Lot No.1 5—
Block No. _
CONSTRUCTION INFORMATION:
A Itlo work to a er orme under
this permit — check
a appy:
HVAC E] Gas Tank
Gas Piping
Shutters
Q Windows/Doors
11 Electric ❑ Plumbing
Sprinklers
M Generator
Roof Roof pitch
Total Sq. Ft of Construction:
SFt. of First Floor:
_
Cost of Construction: $ y ` n(7. OQ
Utilities:.
Sewer 11 Septic
Building Height:
OWNER/Esse k:
CONTRACTOR:
Name 0.\.lrnOnA o c, A _
Address: I a_► I t2�J (C rid 2d
City: LLJ S -Lj ,U CA - State"
Zip Code: 3y, 9 S LI Fax:
Phone 3
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: fNGl l
Company: CLO AIIC ►moi
Ac dress: (o fJ E_ crt Aw�4 1)- I
City: � e- V Stater
Zip Code: 3LMei
Phone No. -1-1 1 � JL Lt 15—
E-Mail:
5—E- ail: ,r(40,. -)e-, c, i 0--r-
State
mSt to or County License: we i (�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
N ORTGAGE COMPANY: _ Not Applicable
N me:
Address:
Address:
City: _ State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zi : Phone:
1 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 wil authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rule;, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and rev ew 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 anc St. Lucie County Amendments.
The following building permit applications are exempt from undergoir g 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 Cornmencement 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 financin , consult with lender or an attorney before
commencing work or recording your Notice of Commence ent. _
Signature of Owner/Lessee/Contractor as Agent for Owner
s
Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ima-a-41ry OD COUNTY OF I" i cxe+/n/�J C O
The forgoing instrument was acknowledged before me
this ;;?_J day of /9C �Oke g r— 20 [�0_by
42r, l rtk JA) a LE I -_E n
(Name of p rson acknowledging )
(Signature of Notary Public- ate of Florida
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Awl ce.:
Commission No. ? 6toz (§f IOr S3bldX3
RL99VZJJ V N0IS9IWWO3 AW.41
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged before me
thi � day of 20 fe by
(Narne of person acknowledging)
q
O LL N
(Signature ofNotary Pub is S to of Florida )
Q
_=c_nrn
c
Per onally Known _f_ OR Produced Identification
-02
Typ a of Identification Produced
U
fission No. {—l` 7 Seal
--?� /
'
v �
LM
SUPERVISOR PLANS VEGETATION I SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
Certificate of Product Ratin
AHRI Certified Reference Number: 7600905 Date: 10/20/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: RA1448AJ1
Indoor Unit Model Number: RH1P4821STAN
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,
MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, 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 rafting 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): 45500
EER Rating (Cooling): 11.70
SEER Rating (Cooling): 14.00
IEER Rating (Cooling):
` Ratings followed by an asterisk (") indicate a voluntary rerate of previously published data,
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no represent
the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damag,
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only
directory at www.ahridirectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall
confidential reference purposes. The contents of this Certificate may not, in whole or it
enteredinto a computer database; or otherwise utilized, in any form or manner or by a
personal and confidential reference.
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahridire
and enter the AHRI Certified Reference Number and the date on which the certificate v
which is listed above, and the Certificate No., which is listed at bottom right.
©2014 Air -Conditioning, Heating, and Refrigeration Institute
accompanied with a WAS, which indicates an involuntary rerate.
Ions, warranties or guarantees as to, and assumes no responsibility for,
of any kind arising out of the use or performance of the product(s), or the
r models and configurations listed in the
mly be used for individual, personal and
part, be reproduced; copied; disseminated;
iy means, except for the user's individual,
y.org, click on "Verify Certificate" link
issued,
FICATE NO.:
AMI
AIR-CONDITIONING, HEATING.
& REFRIGERATION INSTITUTE
,,, m,aka like bette....
131214452491507432