HomeMy WebLinkAboutLarson applicALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: July 18, 2017 Permit Number:
Kai N
Vlum' iiii
Building Permit Application
11 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 8 Lake Vista Trail 104
Legal Description: VISTA ST LUCIE BLDG 8 UNIT 104 (OR 1637-543, 544
Property Tax ID #: 3422-500-0102-000-5
Site Plan Name: William Larson
Project Name: Flynn'sAC
Setbacks Front Back:
Right Side: Left Side:
Replace a 1.5T, 14.25 seer, with a 5KW HTR AC System
Lr MVAC L__j Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3770
Name William Larson
oerrnu —cnecrc do Judl apply:
Gas Piping _Shutters
Sprinklers Generator
S Ft. of First Floor: _
Utilities:D Sewer El Septic
Address: 1600 NE Dixie Hwy 1-101
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 252-474-4819
Lot No.
Block No.
Windows/Doors
11 Roof = Roof pitch
Building Height:
Name: Joseph Flynn
Company: Flynn's AC Services
Address: 1323 SW Thelma St
City: Palm City State: FL
Zip Code: 34990 Fax: 772-781-1307
E -Mail: Phone No. 772-283-4114
Fill in fee simple Title Holder on next page ( if different E -Mail: mjb@flynnae.comcastbiz.net
from the Owner listed above) State or County License: CAC055482
IIIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
_Not Applicable
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 your Notice of Commencement.
slgr� e of Ow9gr/Lessee/Contractor as Agent tar Owner
20 nby
Wature of Cofit or/License Holder
STATE OF FLORIDA
(Name of person Acknowledging
1,
SEA TURTLE
STATE OF FLORU
(Signature of Notary Public- St' a of Florida )
COUNTY OF
(>�aJ,
M
OR Produced Identification
/ion
COUNTY OF
1R �TY` d
The forgoing iinstrUWntwas acknowledged before me
this day of� 20 lby
fog'sh fj� kw
(Name of persdri acknowledge g )
(Signature of Notary Publi • S to of Florida
Personally Known 3' Produced Identification
Type of Identification Produced
The forgoing instrument was acknowledged before me
this dayof
20 nby
lowlt
SUPERVISOR
(Name of person Acknowledging
VEGETATION
SEA TURTLE
MANGROVE
(Signature of Notary Public- St' a of Florida )
COUNTER
REVIEW
Personally Known
OR Produced Identification
/ion
Type of Identifica
REVIEW
Commission No. J BtOtiYn Commission No. 1i NOT
BLJC
NOTARY PUBLIC STATE OF FLORIDA
Revised 07/15/2014 cim"0003M qlww� Edna 1011/2020
EXPIrM 1011/2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
A"101 l.Q CERTIFIEEr
www.ahridiref.tory.org
AHRI Certified Reference Number: 8455870 Date: 7/18/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: TC4B1821
Indoor Unit Model Number: AP18BX21+TXV
Manufacturer: CHAMPION BY JOHNSON CONTROLS
Trade/Brand name: CHAMPION HEATING AND COOLING
Region: Southeast and North (AL, AR, DC, DE, FL, GA, Hl, 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.
`Ratings followed by an asterisk (') indicate avoluntary remte of previously published data, unless accompanied with a WAS, which indicates an involuntary remte
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This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual, personal and
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confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated;
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& REFRIGERATION INSTITUTE
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1314488_969217B78
OO 2014 Air -Conditioning, Heating, and Refrigeration Institute
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