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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i - O 1'7 Permit Number: • - 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 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROVEMENT LOCATION: Address: Q `1 1G dt r'4 ' PMN c)P, Legal Description: a CtAT'F3 Property Tax ID #: � �(� � �C7Qt (� C� oc� —,Q Lot No._i 1 O Site Plan Name: Block No. Project Name Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: X�PC-C QAR Q1-t<� '-yam \ C) tJ CONSTRUCTION INFORMATION: Additional work to eeppertorme under this permit - check all that appy: Zechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: '2 Sq. Ft. of First Floor: Cost of Construction: $ 3'-100 Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: Name A!:La_iOP (-t' �_ (AC!'" DQ l�L� LLL�1 Address: �t .+2.n-�- el'ae City: � - �Ve�'�e State: eL_ Zip Code: Fax: Fax: Phone Nc(_nnn't� 4(k O o_ �C>� E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: N a m e: �' lZA. lc - r✓° A e�ET X21 c Company: Address:S'U rAt-z City: PSL. State �!L_ Zip Code:_ Fax: Phone No. 7 -1 '2.. - `8� k - 7514 E -Mail: -PtYT i !>L�h Cx4�:) . Lb u State or County License. (26-0 S1 ""2,<; if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: State: _Not Applicable OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I 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 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 commencing work or recording yoyr Notice of Commencement. ature4fowner/ Agent/ Lessee Signature of Corpatfor/LicenseZId:* STATE OF FLORIDA COUNTY OF_ Luz -e The fgrng instrument was acknowledged before me thi day of 20 17 by (Name of p n acknowledging ) A',/.J, (Signature of Notary Publ' State of Florida ) Personally Known Notary Produced Identification Type of Identification Produced Commission No. ;r0.y Py, DEBO%S*MSSELL Z= Notary Public - State of Florida ` Commission # FF 179630 goo- •'Nly Comm. Expires qov 30, 2018 REVIEWS FRO c I' IK;Fii"OR COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014 STATE OF FLORIDA COUNTY OF - L -t, Xa iP The for Ing instrument was acknowledged before me th621nay of 20_n by (Name of p n acknowledging ) (Signature of Notary Publi State of Florida) PersonallY Known OR Pro u e d t Type of Identificat �o4;RY PUa��, uttlun�Hn nCbtf LL • ` = Commission No. - .= NoComm 11E 179630da llo 61t o" dP� OF F� sstary My Comm. Expires Nov 30, 2018 _ PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW 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: 7493633 Date: 1/27/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1430AJ1 Indoor Unit Model Number: RBHP-21 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 party testing: Cooling Capacity (Btuh): 29800 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling). ' 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(&), or the unauthorized alteratlon 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. personal and confidential reference. AIR-CONDITIONING. HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at dick on " link WV ,Hake life hertcr'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 CERTIFICATE NO.: 131299957342002015