HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; 8/9118 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Mechanical Q
PROPOSED IMPROVEMENT LOCATION:
Address: 9156 PUMPKIN RIDGE, PORT ST LUCIE
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE AC CHANGEOUT
1 - 5 TON RUUD SYSTEM, 16 SEER, 8KW
CONSTRUCTION INFORMATION:
Additional work toEJ0 bje.performed undert is per —check all that appy;
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Q Generator �Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 5500.00 Utilities:Sewer E]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name MICHAEL JONES Name: PHILIP NISA JR
Address:9156 PUMPKIN RIDGE Company: NISAIR AIR CONDITIONING
City: PORT ST LUCIE State: Address: 3700 S. US HIGHWAY 1
Zip Code: 34986 Fax: City: FORT PIERCE State:FL
Phone No.917-974-0083 Zip Code: 34982 Fax:
E-Mail; Phone No. 772-466-8115
Fill In fee simple Title Holder on next page(if different E-Mail: KRISTIN@NISAIR.COM
from the Owner listed above) State or County License; CAC041199
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:MICHAEL JONES N a me•PHILIP NISA JR
Address:0156 PUMPKIN RIDGE,PORT ST LUCIE Address: 8156 PUMPI(IN RIDGE
City: PORT ST LUM State: City: FORT PIERCE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name'
Address:smo s.US HIGHWAY 1 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 vyill 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 fhJt inspection. If you intend to obtain financing,consult wilender or an attorney before
commencin ork or recordin our Notice of Commencement.
B J
fl
I� I
Signatur of Ow er/Lessee/Contractor as Agent for Owner Signature 311LORIDA ontra /License Holder
STATE F FLORIDA STATE O
COUNTY OF sr LUCIE COUNTY OF ST LUCIE
I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this BTH day of ALIGuBr 20_ by this 9TH day of AUGUST 20_ by
PHILIP NIRA JR PHILIP NIBA JR
Name of person making statement Name of person making statement
Personally Known xx OR Produced Identification Personally Known xxx OR Produced Identification
Type of Identification Type of Identification
Produc _ Produc
J
Avb�
Oigiiature of Notary Public-State of Florida) (S g ature of Notary Public-State of Florida)
RIS� IjBA
Commission No. FEB.,Y,20,o ;jI'!�7' T1N BAIT9H ?8 mission No. FEB.IYYO K ITSHO�TS
MV COMMISSIION#F ! MY CO!tifMi$SIQiw *FFZ01.
EXPIRE$Fobr wry-tg _ .EXPRiE3 F0bfWY t-2QlR_
ale wioa com ' can
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17 _.,_....
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 31, 2016,
r
Certificate of Product Ratings
AHRI Certified Reference Number:201295248 Date:08-09-2018 Model Status:Active
Old AHRI Reference Number:7943714
AHRI Type:RCU-A-CB
Outdoor Unit Brand Name:RUUD
Outdoor Unit Model Number (Condenser or Single Package):RA1660AJ1
Indoor Unit Model Number(Evaporator and/or Air Handler) RH1T6024STAN
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.
The manufacturer of this RUUD product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2,Performance Rating of Unitary
Air-Conditioning&Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored,independent,third party testing:
Gaoling Capacity(A2)-Single or High Stage(95F),btuh:58000
SEER: 16.00
EER(A2)-Single or High Stage(95F) : 13.00
,"Active'Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are being
marketed but are not yet being produced."Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Retinas that are a000moan ed by WAS indicate an involuntary re-rate Tho new oubGshad rating is shown alone with the previous(i.e.WAS)retina.
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 shell only be used for individual,personal and
confidential reference purposes.The contents of this Certificate may trot,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,HEATING,
CERTIFICATE VERIFICATION i REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verity Certificate"link vre make Iffe 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.
02018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: X31793184011334549