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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Qk r Date: Permit Number: I T_ - 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: 168 PEPPER LN Legal Description: BAY TREE LOT 31 (OR 810-867: 1116-2566: 2704-755; 3504-597: 3506-1509) Property Tax ID#: 4511-503-0037-000-3 Lot No.31 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION`OF,F WORK: I, d CONSTRUCTION INFORMATION Additiorial work to be nertormed under t ispermit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers ElGenerator i[] Roof Roof pitch Total Sq. Ft of Construction: S3624 . Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer F-]Septic Building Height: I OWNER/LESSEE: CONTRACTOR: Name Patricia A Dillon Name: RICHARD LEVINSON Address: 168 PEPPER LN Company: SERVICE AMERICA City: Jensen Beach State:FL Address: 2755 NW 63RD CT Zip Code: 34957 Fax: City: FT LAUDERDALE State:FL Phone No.772-229-5695 Zip Code: 33309 Fax: 954-977-3591' E-Mail: Phone No. 954-979-1100 Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM from the Owner listed above) State or County License: CAC014619 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. L� I e ,. e SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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:l 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 Commenceme ay result in your paying twice for improve o y ur property. A Notice of Commencement must ere r d and posted on the jobsite before a ,first p ction. If you intend to obtain financing, consul wi h I r or an attorney before comme cin w r or ecordin our Notice of Commencement. s Signature of ssee/Co tractor as Agent for Owner SignaturContra r- icen older STATE OF FLO IDA ,,, STATE OF FLORIDA COUNTY OF rnCOUNTY OF b rhWr' The fo going instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 'h,}pnlbcr 20 Alby this vin day of i°1r)))r 201 by rJA CIY L�1vjh�c�n _i11(�1Y�lr� ley'`n.5t�n (Na of person acknowledging) (Name of person acknowledging) 4 kk­ &t) (Signature#Notary P blic-State of Florida) (Signature of N ary Public-.State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Prod Type of Identification Prod u'e ,'•"----[y--y_y/_�+ CZ­F4_'1:%:�'--_ PATT1E J0 NETTLE., FF�' ' : F� �O tdE?T� Commission No. ;� M`��UIMISSION#FF9529 q mmission No. ;;Z: ��§eat AIS$IOPJ rY 2020 �,,,;, �Yz ;. Yplt �January 21F pZ9ea .i��ppEXPIRES January 21, o� a ctarySernce c:w„ ..,,.....�,` r cryit@ Cum Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS IOU wMad CERTIFIED Certificate of Product Ratings AHRI Certified Reference Number: 8715778 Date: 9/28/2017 Product:Variable Speed Mini-Split Air-Conditioner,with Remote Outdoor Unit-Air-Source, Free Delivery i li Outdoor Unit Model Number: MUY(-GL09NA-U1 Indoor Unit Model Number: MSY-GL09NA-U1 Manufacturer: MITSUBISHI ELECTRIC COOLING&HEATING Trade/Brand name: MR.SLIM I Series name: 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 regions)for which they meet the regional efficiency requirement. Manufacturer responsible for the ratmg`ofthis system combination,Is MITSUBISHI ELECTRIC COOLING& HEATING i `.. Rated as,fbllows in accordance with AHRI Standard 210/240 2008 for Unitary,Air=Conditiomng and Air-Source Heat Pump;Equlpment and subject to verification of rating accuracy by AHRI sponsored, independent,.third partyldsting: . "17r Cooling Capacity(Btuh) 9000 ` . � t f EEF Rating (Cpoling) SEER Rafin I, CERTIFIED RATINGS FOR VARIABLE-SPEED,MINI-AND MULTI-SPLIT SYSTEMS ARE VALID FOR ALL COMBINATIONS OF INDOOR UNITS (BASED ON COMBINATION TYPES)WITH THE SPECIFIC OUTDOOR UNIT LISTED ABOVE AND IN THE AHRI DIRECTORY OF CERTIFIED EQUIPMENT.VISIT WWW.AHRIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON THIS CERTIFICATE IS ACCURATE.SEARCH ON THE AHRI REFERENCE#TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. ' I Ratings followed by an asterisk(•)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. I 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.ahrldlrectory.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 CO HEATING, CERTIFICATE VERIFICATION &REFRIGEGERATI ION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectgry.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 listed above,and the Certificate No.,which is listed at bottom right. nI 131510964679549781 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: