HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: 9/20/2017 Permit Number:
RECEI'.^D SEP 2 0 2017
_ z
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3122 SCARLET TANAGER COURT
Legal Description: EAGLE'S RETREAT TO SAVANNA CLUB PHASE 2 (PB 43-21) BLK 58 LOT 32 (OR 2249-1648)
Property Tax ID#: 3424-702-0042-000-2 Lot No. 32
Site Plan Name: Block No. 58
Project Name: CAMUSO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORk:"" �
4 TON
14 SEER
10 KW
CONSTRUCTION 'INFORMATION:
Additional work toa er orme under this permit—check a appy:
HVAC E] Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 4850.00 UtilitiesSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name MARY CAMUSO Name: MARK A VINES
Address: 3122 SCARLET TANAGER COURT Company: AZTIL
City: SAINT LUCIE COUNTY State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34997 Fax: City: WEST PALM BEACH State: FL
Phone No. 978-387-4605 Zip Code: 33415 Fax:
E-Mail: Phone No. 561-433-2197
Fill in fee simple Title Holder on next page (if different E-Mail: PERMITS@AZTILAC.COM
from the Owner listed above) State or County License: CAC049253
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW MFORMIATI>O-):
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: MARYCAMUSO Name:MARKAVINES
Address: 3122 SCARLET TANAGER COURT Address: 3122 SCARLET TANAGER COURT
City: SAINT LUCIE COUNTY State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2540 S MILITARY TRAIL 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 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 our Notice of Commenceme
Signature of Owner/Lessee/Contractor as Agent for Owner Sig o Co ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of ,20_ by this 20 day of SEPTEMBER 20_ by
MARK A VINES
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
-------------
(Signature of Notary Public-State of Florida ) a ure of ary 1, ta`e dP1fMiWARD GIFFORD
MY COMMISSION#FF077427
Commission No. ea Commis ' n No EXPIRE�S&Wt)mber 17,2017
(407)398-0153 FloridallotaryServicexom
REVIEWS FRONT ZONING SUPERVISOR/ PLANS VEGETATION' SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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1
certificate of Product Ratings
AHRI Certified Reference Number: 7492911 Date: 9/19/2017
Product: Single-Package Air-Conditioner,Air-Cooled
Model Number: PAJ448000K**OA
Manufacturer: TEMPSTAR
Trade/Brand name: TEMPSTAR
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: R41 OA AC SPP
Manufacturer regpondible'for'the rating of this system combination•is TEMPSTAR
Rated,as1011ows in=cordanceiwith AHRI Standard'21,0/240-20081 for Unitary,,Air=Conditioning and'Air-Source
Heat
',;testing,-'1Equipment and subject t er'ification of rating accuracy,by A'HRl=sponsored; ind"ependent�third
partam--rte- r— � ! 1
�Oooli� n'�Ca jai cit 1'Btu 47000 EP IQ g PY�(� ) IIF - E
ED)" ;
I !EERAbUm.g((Gooling): 11.50 14-
Py
Ml .FlIj T T g @ Fir�9oaf
,SEERIRating+(cooling): 14.00
'Ratings followed by an asterisk(h 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)fisted 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 rated on this Certificate.Certified ratings are valid only for models and configurations listed in the
directory at www.ahridirectoryorg.
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;
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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 www.ahridirectory.org,click on"Verify Certificate'link we make life better-
and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which is fisted above,and the Certificate No.,which is listed at bottom right.
02014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 131503240476003122
SEP725-2017 MON 01:39 PM AZTIL AC FAX NO, 5614340018 P. 01/01
. ...:.... . . ..
I.. : i.. a�C .IWa.. :RU1 Q.N:.L[EN l�AU11.1N.Q'�;NI/�TIQ�:
DESIGNER/ENGINEER: _Not/applicable MORTGAGE COMPANY: _Not.Applicable
Name'MARY CAMUSO Name-
MARK AVINES
Address-3122 SCARLET TANAGER COURT Address:
3122 SCA
TANA�GRCaUFZT
City: SAINT LUCIE COUNTY State, City' WEST PALM aWH State:
Zip; Phone Zip: Phone:
FEE SIMPLE TITLE HOLDVR: -Not Applicable. BONDING COMPANY: Not Applicable
Name, Name'
Address•254aSMILITARY TRAIL 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 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 thr.--Drst inspection..If you'intend to obtain financing,.consult with lender or an attorney before
COMMAK'1 work or re din our Notice of Commenceme
Ignature of Owner/ essee/Contractor as Agent for Owner Sig o Co ractor/License Holder
STATE OF FLORIDA
PQ STATE OF FLORIDA
COUNTY OF COUNTY OF PALmorAcH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 4f I/ n 2
0J2 by this20 day of SEPTEMBER 20_ by
MARK A VINES
Name of person making statement Name of person making statement
Personally Known,_„_OR'Produced Identification Personally.Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
�NmgnXieofNota a ure of ary zllijARp C,IFFORD
' !"s MY COMMISSION#FF077427
. JOWL!E Rp 3�aq., :mission No/ ;' :"= Commis ' n N 'e EXPfREmber 17,20T7
Y COM to a N IIFF07/•
- ��;P f. (407)3ea-0153 FIur)daNatq9erolce,COm
t, dt. EXPIRES December 2017
o1Fl -r.NIIX:CO")
REVIEWS FRONT ZONING SUPIRVISOe PLANS VEGETATION' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17