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HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:03/15/2011 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 X-,-r-->'-- PERMIT APPLICATION FOR:Mechanical Address:5lo 13 6had~LoJ1e5 Legal Description:Itrnber tl'l....l6e.E S+tl::Ie-s PropertyTaxID#:2W1.-lfDl-CQ2.o-QCO-lf _ Site Plan Name:_ Project Name:_ Setbacks Front._ Lot No._ICp-'--__ Block No._ Back:Right Side:Left Side:_ Shutters D Generator o Windows/Doors DRoof Total Sq.Ft of Construction:_ (bOCostofConstruction:$,p2:£X):::.-- S'f.£!;of First Floor: Utilities:USewer D Septic Building Height:_ Company:-\h..L---rrea~r~ State:.£L.Address:Ot eK.uG.~~~~~==----------. City:k>1'2-~State:~ Zip Code:~to 2.Fax:112 -4lo::>'lfqyS Phone No.1'7~-4lo'5 -t LPO\e E-Mail:OtdVtlf\±n.¥W~i+s@~\.CoM... S ate or County License:M-C..03CtloCoG n~-t!::~7 If value of construction is $2500 or more,a RECORDED Notice of Commence nt is required. "~SUPlnEMENtAL GONSJRUCnON lIEN'LAW INFORMATION:,:.",c .:",'. ,.."",.'..'.'.-:,.........., 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: 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 countii makes no representation that is granting 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,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 commencinz work or recording your Notice of Commencement. ~<~//.f1~~IVJC;;~~7fj~ .~gr(ature of Owner!Agent!Lessee Signature of Contractor/License Holder STATE OF FlORI~i LUb~STATE OF FlORI~•.:Lu.c;r::JCOUNTYOFfieCOUNTYOF'<;()un-( The forgoing instrument was aCknowled~efore me The fo~oing instrument was acknowledged before methis1St!.day of rYU:trcJ\..,20 by this \'5-day of Norc..h .201 "Iby<:f.:D/If-h,z.lJ(G/1wel T./)tII-'iJO "'/ (Name of person acknowledging)"'-(Name of person acknowledging) /P,~t~\IIHII';fIII/'L~p aL AI .,\\\\11111/"',,~""'",;t~./" (Signature of Notary .•.•..~~~f§f Frof~(Signature of Nota?C-Stat~!t~:'i!l'iJ"f%0;,~.'1.\:)\i·.v--~-~.;9"'~iI'IRES ".<?-0 Personally Known -UJ i~'prca'l~<i-~~ication ___Personally Known oRi#~~~~~ntifici\j~ Type of Identificatio~~<\d •i jJ:}i::Type of Identification producci;lltJ if::J ;:,'ff ~~'5~ ~-••v-{.-:~~t.::§::~:~s •F ~~:L1.J~::.2...~o ~~ss,£§.I--::':Commission No,"',[1',\O~.~)Commission No.'~••v;n (~%~•••~~:?-/.••••••••••«~~~-,74 ,~o"':~ '/IIII/l NOTf>,~\",,,~•••~':Jv..o;.o ~.;:::.~...........~~\~":,~ "111 ./XUTA.~:\\" Revised 07/15!2014 III/IIIHI\\\\\\ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVECOUNTERREVIEWREVIEWREVIEWREVIEWREVIEWREVIEW DATE RECEIVED DATE COMPLETED A.~!!IGERrl~IEI)® www.ahridirectory.org This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2016. Certificate s AHRI Certified Reference Number:8908415 Date:3/15/2017 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:TC7B6021 Manufacturer:CHAMPION BY JOHNSON CONTROLS Indoor Unit Model Number:AHX61 Manufacturer:CHAMPION BY JOHNSON CONTROLS Trade/Brand name:CHAMPION HEATING AND COOLING Region:All (AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,10,IL,lA,IN,KS,KY,LA,MA,MD,ME, MI,MN,MO,MS,MT,NC,NO,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 onlyb~installed in region(s)JQrwhich they meet the regional efficiency requirel11911t. Series name: Man~facturer responsible for the rating of this system combination is CHAMPION BY JOHJ'tSON,'CONTROLS Ratec:laS f6110ws in accordance with AHRI Standard210/240~2008 for Unitary Air-Conditioning anc:lAir~Source HeatPumpEquipm~nt~nd subject toverificationof rating accuracy by AHRI~spons()red,in~epel1dentithirdparty.testlnq:... EER Rating (Cooling): SEER Rating (Cooling): lEER Rating (Cooling): 13.00 16.00 "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(s),or the unauthorized alteration 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. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org.click on "Verify Certificate"link 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 AIR-CONDITIONING,HEATING. &REFRIGERATION INSTITUTE CERTIFICATE NO.:1313406368898486:3.3