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BUILDING PERMIT APPLICATION
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. 1014117 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential X Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 0220 Wentworth Lane' Port Saint Lucie, FL 34986 Legal Description: POD 20A AT THE RESERVE PUD Il CASTLE PINES LOT 75 (MAP 33127S)(OR 3679 17) Property Tax ID #: 3327-801-0083-000-7 Lot No. 75 Block No. Site Pian Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Install Rheem 3.5 TON, 16 SEER, 10 KW Heater, VERTICAL, Straight Cool Split System. LIKE FOR LIKE CONSTRUCTION INFORMATION: itiona wor to flasTank Dime un ert ss permit—c ec a app y: HVAC F]Gas Piping Shutters a windows/Doors 1:1 Plumbing OSp rinklers LJ Generator O Roof Root pitch Total Sq. Ft of Construction: 1750 S. Ft. of First Floor: Cost of Construction: $ 4300 Utilities: { Sewer 1�1 Septic Building Height: OWNER/LESSEE: Name Hernan Welch Address: 9220 Wentworth Lane, Port Saint Lucie, FL 34986 City: Port Saint Lucie State: FL Zip Code: 34986 Fax: Phone No. 510-390-4441 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name; Company: Air Temp Air Conditioning AAArocc. 651 NW Enterprise Drive #107 City: Port Saint Lucie State: FL Zip Code: 34986 Fax: Phone No. 772-340-0740 r_AA,;i. airtempac@yahoo.com State or County License: CAC1814837 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION TEN LAW INFORMATION. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name, iceman Welch Name: Address: 9220 Wentworth Lane, Port Saint Lucre, FL 34986 Address: 9220 Wentworth Lane, Port Saint Lucie, FL 34986 City: Port Saint Lucie State: City: Port Saint Lucie State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 651 NW Enterprise Drive #107 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 thepermit 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. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Saint Lude TheXroing instr nt a acknowledged before me hisay. :of_ k -k 20A by -=='A V- 1 - Name cif -p raking statement so PersonallyKndwn OR Produced Identification Type of IdeAtificatian Produced (Signature of Nota ublic- State of Fforida) _ 1 ., CHERYL A. FINK Commission No. s8 45t�ery Public State of My Comm. Expires Mar 2 'F.._„op- Commission # FF 10 REVIEWSI FRONT I ZONING COUNTER REVIEW DATE RECEIVED BATE COMPLETED Rev. 8/2/17 Signature of Contracto /License Holder STATE OF FLORIDA COUNTY OF Saint Lucie The f ping instr ten wr acknowledged before me this Vlay of d 201 by . Name of person aking statement Personally Known OR Produced IdentrficatIon Type of Identification Produced ff of Notary,Pbblic- State of Florida ) ssion No. 2018 i7 SUPERVISOR IPLANS I VEGETATION REVIEW REVIEW REVIEW (Seal)CHERYL A. FINK 3 Notary Public - State of FI e My Comm. Expires Mar 28, REVIEW l REVIEW owaM CERTIFIED° www.ahr1ditoctory.arg This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. Product Ratings AHRI Certified Reference Number: 7942888 Date: 10/2/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1642AJ1 Indoor Unit Model Number: RH1T4821STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD 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, Wl, 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 2101240-2008 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): 41500 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 LEER 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(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 CONDITIONANWRI 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 users individual, AIR-CONDITIONING, BEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATIONsve make life better" The information for the model cited on this certificate can be verified at www.ahrldlrectory.org, click on "Verify Certificate" link and enter the A14RI 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. CERTIFICATE NO.: 131514482224146( ©2014 Air -Conditioning, Heating, and Refrigeration Institute