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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