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�'L/ LS i IN MAI ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Numb] Pla ming and Development Services Bu/dingand Code Regulation Division Z3O0Virginia Avenue, Fort Pierce 834982 Phmne:(77Z)4621553 Fax: (772)463-1578 {,ODlD08FCiGlResidential Yea PERMIT APPLICATION FOR: Mechanical Address: 10205 CROSBY PL Legal Description: POD 28ATTHE RESERVE REPLATCYPRESS POINT (PB 40-3)LOT 117(OR 30&8-475) PGA AREA PnnpertyTax 0#: 3327-710-0019-000-9 Site Plan Name: Project Name: Setbacks FrontBack:__ Right Side: — Left Side: Lot No.— Block No. LIKE FOR LIKE REPLACE AIR CONDITIONING UNIT. iOSEE EATER( MA|NHOUSE UNIT CHAMPION NAME BRAND AHRI8QU142O TC7B4221 AE42CX21+TXV zoitiona|work to be pertormed HVAC L~�6asTank unde/tNs it check all L=JShutters apply: Windows/Doors asPiping � ) �~�E|ectric L=�Plumbing �� | |6prink|ers L~�Generator L~��Ron[ Total Sq. FtofConstruction: Cost nfConstruction: 5000Utilities: []Sewer 0 Septic Name JAMES LFR0t Address: 10205 CROSBY City: PORT STLUC|E State: FL Zip Code: 34986 PhoneNo.7723443044 E-Mai|:jomeaf ok2@gmuiioom Fill infee simple Title Holder onnext page (Kdifferent from the Owner listed above) of __ Building Height: Name: A/C DOCTORS INC Company: A/C DOCTORS INC Address: PO BOX 1527 City:State: JENSENBEACHFL Zip Code: 34958 Fax: 7728075700 Phone No. 7723443944 E-Mail:ACDDCTORS|NC@3MA|LC0M State or County License: CAC058461 Itvalue ofconstruction is $250Oormore, aRECORDED Notice ofCommencement iarequired. 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 record �ay he jobsite before the first inspection. If you intend to obtain financing, consult with der o�an before commencing work or recording your Notice of Commencement. _ Signature of Owner/ Lessee/Agent •, •1 f A *01 L •' The forgoing instrument was acknowledged before me this _ day of 1 20 _by Signature of Contractor/License Holder STATE OF O . i COUNTY• The for oing instrument was acknowledged before me this day of" f ' G-�#''� _ 20 by (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary Public- State of Florida) (Signature o Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) Revised 07/15/2014 Personally Known OR Produced Identification Type of Identification Produced i" i -)J k (,J 1 -- $oti10y po", � MARY Lav€: MArn$ Commission No. '` MY JiSION#0Gx EXPIRES: March 6, 2029 REVIEWS FRONT DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable Name: SEA TURTLE Name: Address: COUNTER Address: City: State: City: State: Zip: Phone: REVIEW Zip: Phone: FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 record �ay he jobsite before the first inspection. If you intend to obtain financing, consult with der o�an before commencing work or recording your Notice of Commencement. _ Signature of Owner/ Lessee/Agent •, •1 f A *01 L •' The forgoing instrument was acknowledged before me this _ day of 1 20 _by Signature of Contractor/License Holder STATE OF O . i COUNTY• The for oing instrument was acknowledged before me this day of" f ' G-�#''� _ 20 by (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary Public- State of Florida) (Signature o Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) Revised 07/15/2014 Personally Known OR Produced Identification Type of Identification Produced i" i -)J k (,J 1 -- $oti10y po", � MARY Lav€: MArn$ Commission No. '` MY JiSION#0Gx EXPIRES: March 6, 2029 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Product:AHRI Certified Reference Number: 8899634 Date: 10/27/2017 ! ♦• '! Condensing Unit, CoilBlower Outdoor Unit ModelTC7132421 CHAMPIONIndoor Unit Model Number: AE24BX21+TXV • •CONTROLS Trade/Brand name: CHAMPION HEATING [ COOLING Region:AR, AZ, CA, CO, CT, DC, r r . r • r • • .. r, RegionNote: anuary• eligibleinstalled in all ! i 2016. Beginning July 1, 2016, central air conditioners. + only be installed in region(s) for which they meet the regional efficiency requirement. IEER 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.ahr€directory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and A.&w 1 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-CONDITIONING, HEAPING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahrid lrectory.arg, click on "Verify Certificate" link Wo ruake 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. 7 131535$5123$571, ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: