HomeMy WebLinkAboutKellyPermitSubmittalALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/15/2017
Permit Number:
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: Castle Pines Condominium (OR 1571-492) Phase IV Unit 2312 (OR 1610-2014)
Property Tax I D #: 3327-502-0042-000-0
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
A/C Change Out same for same. Trane 2 ton 16 SEER 4TTR6024J1000A / TEM6AOB24H / 5kw
Heater. Existing Duct Work
CONSTRUCTION INFORMATION:
A ititiona wor to a er orme un er t ds perrnit — c ec a appy:
I'J HVAC Gas Tank ❑Gas Piping _ Shutters
LJ Electric ❑ Plumbing Sprinklers I Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4659.00
OWNER/LESSEE;
Name
Address: ci
SFt. of First Floor: _
Utilities:Sewer D septic
City: I' C) , State: FL
Zip Code: 34986 Fax:
Phone No. (772)359-1933
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
CONTRACTOR:
0 windows/Doors
ElRoof Roof pitch
Building Height:
Name: ")
,Company: Adam's Air Conditioning
Address: M 1;r ""
City: State: FL
Zip Code: 34986 Fax: (772)878-3951
Phone No. (772)337-6559
E -Mail: Lynette@adamsairconditioning.net
State or County License: CAC 1814146
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
ate.
Permit Number:
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: Castle Pines Condominium (OR 1571-492) Phase IV Unit 2312 (OR 1610-2014)
Property Tax I D #: 3327-502-0042-000-0
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
A/C Change Out same for same. Trane 2 ton 16 SEER 4TTR6024J1000A / TEM6AOB24H / 5kw
Heater. Existing Duct Work
CONSTRUCTION INFORMATION:
A ititiona wor to a er orme un er t ds perrnit — c ec a appy:
I'J HVAC Gas Tank ❑Gas Piping _ Shutters
LJ Electric ❑ Plumbing Sprinklers I Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4659.00
OWNER/LESSEE;
Name
Address: ci
SFt. of First Floor: _
Utilities:Sewer D septic
City: I' C) , State: FL
Zip Code: 34986 Fax:
Phone No. (772)359-1933
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
CONTRACTOR:
0 windows/Doors
ElRoof Roof pitch
Building Height:
Name: ")
,Company: Adam's Air Conditioning
Address: M 1;r ""
City: State: FL
Zip Code: 34986 Fax: (772)878-3951
Phone No. (772)337-6559
E -Mail: Lynette@adamsairconditioning.net
State or County License: CAC 1814146
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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:
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 dome 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 fir nspection. if intend to obtai financing, consult with lender or an atto y before
cor mmengil w rk or recd ing your Notice of Vmmencement. `�
ure of OViner/ Lessee ntr� -as Age Ow Si re of Contractor/License H
STATE OF FLORIDA i STATE OF FLORIDA
COUNTY OF Saint Lucie ! COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this 15th day of November 20_L9_ by
Name of perso aking statement
Personally Known OR Produced Identification
Type of Identification'"
(SignAture f Notary Public- State of Florida
�Dn�IfllI5Sl0 No. FF948668 LMQT E 14AMIL` ON
My COMMISSION # FF948668
EXPIRES„ January 07, 2020
REVIEWS FRONTI ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The forgoing instrument was acknowledged before me
this 16th day of November ZOI by
ra
Name of person aking`statement
Personally Known OR Produced Identification
Type of Identification
of Notary Public -
No. FF948668N; ETTE HAMILTON
C NMfSSION # FF948668
___V SIRES: January 07, 2020
SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
L www.ahridirectory.org 'A i between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRi Certified Reference Number: 8626099 Date: 11/1512017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 4TTR6024J1
Indoor Unit Model Number: TEM6AOB24H21+TDR
Manufacturer: TRANS
Trade/Brand name: TRANS
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, Hl, ID, IL, [A, 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: XR16
Manufacturer responsible for the rating of this system combination is TRANE
Rated as follows in accordance with AHRI Standard 2101240-2008 for Unitary Air -Conditioning and Air -Source
Heat hump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 24400
EER Rating (Cooling): 14.00
SEER Rating (Cooling): 16.50
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.ahridirectory.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; o
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 INSTITUTEThe information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link
and enter the AHRI Certified Reference Number and the date on which the Certificate was issued, lye inalce life better"
which is listed above, and the Certificate No., which is listed at bottom right.
@2014 Air -Conditioning, Heating, and Refrigeration institute I CERTIFICATE NO 13155245632679227