HomeMy WebLinkAboutBUILDING PERMITALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:/2/15/2-01 LQ Permit Number:_
t----Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ----Residential X-"--'----
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Property Tax ID #:_~!o..4C=<---==--'--Jo...o!.!.~!-!:...~~-=---L._
Site Plan Name:_
Lot No._
Block No._
Project Name:_
Setbacks Front _Back:Right Side:Left Side:_
CONSTRUGTIQN INFORMAtiON:oWindows/Doors
DRoof
Total Sq.Ft of Construction:__-=-_
2c::::::.()QCostofConstruction:$-,,~~=50<-=-_
S~of First Floor:
Utilities:USewer D Septic Building Height:_
~OWN;~~Ril!~S~§iE:,.
NamelEoma.~l.Lt@i'Di'nl ---,-
Address:C1C()cO Ocmn "Beach:Bhld A¢'*tfo~
City::sen-::en ~State:a
Zip Code:,3qtj51 Fax:_
Phone No.LtIC\-23tt-Bf6S3
E-Mail:_
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
,..,''..'{'\.,'~···<'7{j;'"';ifi,:C,'}1tl"':';~~!'SUPPLFMENTAl.C0NSTRUCTION{IENLAWIN80RMATION:'..:..,.,:.•:'../'.......".,'.'.)~:.'i;_.,i
DESIGNER/ENGINEER:_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:
OWNERI CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation asindicated.
I certify that no work or installation has commenced prior to the issuance of a permit,
St.Luciecountx makes no representation that isgranting a permit will authorize the germ it holder to build the subject structurewhichisinconlictwithanyapplicableHomeOwnersAssociationrules,bylaws or an covenants that may restrict or prohibit suchstructure.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,Ido hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codesand St.Lucie County Amendments.
The following building permit applications are exempt from undergoing afull concurrency review:room additions,
accessorystructures,swimming pools,fences,walls,signs,screen rooms and accessory usesto 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 your Notice of Commencement.
V~<~/7.a~~IVJ~~~/7/d~~
.~grrature of Owner!Agent!Lessee II'signature of Contractor/License Holder
STATE OF FlORI~d LLtC!~STATE OF FlORI~~',LC;;e;COUNTY OF '-----u»COUNTY OF ()un-t
The~ing ins~nt was aCknowledmefore me The forgoing ins~nt was acknowledged before me
this -day of ~,20 1(.by 'G'YOf ~.'201/~'by
e....Sflmile!-r ..:.D.l!rhll!J(am l!e./T<.))/J'Y/'JPN/
(Name of person acknowledging)"-(Name of person acknowledging)<,
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{Signature of Notary ~'::~~~~Fr~~(Signature of Nota 7-Stat~$~:i!i9.l ••~"%~,~'l.\)\",'.",,:::~~"~'l.I'IRES ".~
Personally Known ~ff&iR'profl~<i~~~ication Personally Known t O~b'~¢~Mkntifici\j~UJ e......,,~,c-g._---Type of Identification Producellul iif;,~\~'6~Type of Identificatiot;.~c%d 4 ~i-~:'::S¥i
~.e!.-.C6 ~~~;t:C/J~:~:~~.F ~~:u.,;:-::4...·0.;:::,•<::)1::>.:;5_1-.::':~.~Jjt ~~~'Commission No,'::;·'.v ~(~%trff"'':::-~Commission No,~".~~.'~)~.'~'"~_.-f.lp ~~.:~"/..••.•.••,,«-s=~..~()\'o••e ~~'/11111/N01I\?'\\\\,\\;%~••••.••••~~\.~"\.,~
-"II/..J':IOTi\'r'::\\\"
Revised 07/15/2014 111/1/1fI1\\I\"
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
First Co.Certificate of Pr~duct Rating_s_
First Co.Certified Reference Number:0140402 Print Date:8/21/2015
Outdoor Unit Manufacturer:RHEEM RUUO
Outdoor Unit Model Number:RA1424AJ1
First Co.Indoor Model Number:25HX
CoolingCapacity (MBTUH):24.0
EER (Cooling)11.50
SEER (Cooling):14.00
F'lrst Co.certifies that the capacity and SEER values shown are calculated using the methodology in
Sectio"430.23(M)of 10CFR Pat!:430.The calculation protedure utilizes test data collected In accordance
with ANSUAHRI 2101240-2008 and has ootm validated by In Independent test in accordance with DOE
standards.
DOE Requit'am~lnt
EffectiveJuly 5,2011,the U.S.Department of Energy (DOE)Issued a FInal Rule (10 CFR Parts 429-431)that
expands the existing certification,compliance,and enforcement requirements for all covered products,including
ResidentIal and Commercial HVAC products.As part of the Final Rule,all efficiency information for covered prod-
ucts must be on file with DOE.All First Co.ratings have been submitted to DOE.
Cartification Vertlflcatlon
The above rating information can be verified on either of the following web sites:
I=lrst Co.:ratings.firstco.com
DOE:www.regulations.doe.gov/certitication-data Void Date:07/01/2016
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