HomeMy WebLinkAboutBUILDING PERMIT AI I APPLICAB LE IN FO N7UST BE COMPLETED FO R APPLICATI ON TO BE A CCE PIED
Date: 2J412019 Permit Number:
COUNTY
F
Building Permit Application
plonn�ng cn-d Development Services
Building and Code Regulari-on Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone, (772) 462-1S53 Fax: (772) 462-157,8 Commercial Residential
PERMIT -rYPE:HVAC Mechanical AC Change Out
PROPOSED INPROVEM ENT LOCATION:
Addiress: 920:3 Champions WAY, Fort Saint Lucle, Florida 34966 n- .
P rc pe rty Tax I D 9: 3 334.501- 065,-000- LNo-
Site
LAKES AT P VILLAGE CAB 43-3 BL 8 LOT � OR 6 9-1�7�
Plan Name: ( � � ) Block No, E3
Project Name: HVAC Mecharilral AC Changc Out, LIKE FOR LIKE
DETAILED DESCRIPTION OF WORK:
AC Change Out, rnstall I HEErv1 5 TON. 15 SEER, 10 KVV Heater, Heat PuMp Split System, U E FOR LIKE
TI f Tl r ! INFORMATION: -
Additional ro rk to be performed wander this perrra iit— check all that apply-
Mechanical � sT�rtl Gas Piping Sh utters WLriclows/Dears
a Electric _ Pltimbin _ Sprinklefs Generator Roof Pitch
Total Sq, Ft € f Co nstr►a ct i►a n: Sq. Ft. of First Floor_
Cost of Construction: u5,700„00 Utilities: —Sewer — Septic Building Height:
OWNER/LESSEE: CONTRACTOR,
Name Jet Bieronski Name. Telly erkusinno
Address- -9203 Champions WAY C�rnp�ira�; Air Temp Air enditioning, Inc_
Part ant Laasi
ii + t te: Address- 651 NW Enterprise Drive uite 107
Zip Code: 34986 Fax: I U ty= Port Saint Lucie :State: FL
_ - .--
Phone o.630-887- 0._ 71p Code. 34986 Fax. 77 - 81- 07
E-Mail. jetskl23@att.net Phone Nu77 -340-0740
Fill in fee sImpla Title Holder on next page if different E-i all airlempac@yahoo.00m
from the Owner listed above) Ste to o r Co u my Li ce nwse CAC I$14$ 7
If value of constructicn is $25Q0 or more, a RECO R.DED Notice of Cc inmencement 15 required.
If value of HVAC is S7,5D0 or more, a RECORDED N otice of Commencement i!s requir�d.
a .
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE IGN'ERIENG!NEER: Not Applicable MORTGAGE COMPANY: �g Not Applicable
Name. Name.-
Add ress Address:
city: _ stag° city; State-.
Zips: Phonezip: Phone-
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY: —Not Applicable
Name: lrrea
Address: Address, y
City: -- - City_
Zip; Phone: --- Zip- -- Phone:—_
OWNER/ CONTRACTOR AFFIDVIT; ApplicaTion is hereby made to obtain a permit to do the wDrkand lrs�tall,ation as indicated.
I certify tbat no work or InstaIlatien has co ram enced prior to the issuance of a permit,
5t_ Lucie County mak -� no re p resentaTi on that isgranting a permit will authorize-:he permit holder to buiId than subject structure.
which is in conflict with any applicable Horde Owners Association rules, bylaws or and covenaots that may restrict or proh'b't such
structure. Please consult swath your Hama- Own o.rs As5uciati-Gn and review your deed for any restrictions which may apply_
Fn con5ide ratio r, of the granting of this requested permit, G do hereby agree that I will, it all respects, perform the wor
in accordance with th e a Kara vod plans, the PIo ride Bui ld i ng Cocles a n d 5t. Lu cie U u my Am e.nd ryients.
Thee following bufIdl g perrnit applicatioPs @re, exempt from tanderRoing a fuel con eurrency review: roorn additions,
access"r `tructUre , s'wimmIrg p Gls, fences, °galls, signs, screin rooms and accessory uses to another non-resident i:aI use
WARN I N G TO OWN E R o Your fa dare to Recap rd a Notice of Commenceme nt may result in your payi ng twice fo r
improvements to your property. A Notice of Corrlme ncement must be recorded and posted on the jobsite
before the fir-st inspection- if you intend to obtain financing, consult with lender or are attorney before
commengt work pr recordiMyqur No ige of Commencement-
Signature of Owner/ L /Contractor as Agent for Owner Signature of Cant ractor/L nse Frolder
STATE OF FLORID � STATE OF iFLOPJDA
COUNTY OF COUNTY OF �
I
The forgoing In strum
nt was acknow wedged before me The forgeiri instrument was as knowl0ged beforern€
this day of , 20 by this�day of j , �� by
I i '
arr�e o per n r6 n stJernent., Ida c► persprIjrnaking statement_
Personally Known)( OR Produced IdentiffcatiDn Personally Known OR, Produced Identification i.
Type of Identification Type of identification
Produced Produced
l # A
ure o notary Pubilic- State .f I�,r�� � r jQgna re of Notary Public- Stat r r
M1 iw vary f ublir- °I� �r• pyC ary Public s
Donria
Crarrltiis�ora f l + atF� e � 1 brae rya
t ar
GCA 1715 8,
mm i�ra �I .y
REVIEWS FRONT E l fN SUPERVISOR PLANS VEGETATION SEA. TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECE VEl _v
DATE
CC) PLETE�
ev_ =�'
AL Lanp,
on INU CERTIFIED�'
Wry.or4
Certifi
s to Product
AHRI COAMed Ref nce Number : 201 :114:3 Date! : U&15- 1a Mom swus ; Postva
Old AHRI lkeferencD Number: 7512254
AHM Type : F RCU- 8
Outdwr Unit Brand Na" -, FIHEEM
Outdoor Unit Nkydd Number (Cohdemerar Sfnxfile Pas )-. RPI560A.f1
Jndoa.r U rrit Model Nu l7er (EvapLx-wor arAlor Air Handler) RH1 T6024STAN
Th-a IY' Tr,Jfa-CtUraT of this RHE�EM p.rOdrac7t 4s mspom2ble for the raii fg&ih ystem combination,
RatQ0 as fdrmn In ol=orda--we with the latest od tion of ANSLTAk RI 2101 4{�%,ith Addenda 1 and 2, Perfirmaince R Ung of Unitary
Air--,onditiwlrPg & Ai r- rn,rce heat Pump Equipment and wtjorl to rating a ur-acy by AHRI-s pons(mod, incdep[ndont. thifd party testing.
Dlirrg Oapaoo {} )-:5inglc or High � 5 jg
SEER ; 115.00
EER )-Singlie or HiI;h Stagg ( F) 1: ,
Heaung Capacity(H 12) -.Singh ar High Stago (47E) : 56ODD
H PiF ( agioc IV) _ 9.00
-rArW Model $Wtuv We thou than an fil-if�,l Carte Qatian Program Rarlicipa A is curw0y producing AND selknq or-offering fcc sale;OR new rncoele mm atu being
m rkeM hc.t are r l y+ k being p ,lu d,f'r luGii r StoppW N'lacrel Status ara tt3m Wt an,4 IRl OerliN=Hw Pro jram Rarti�+pant is no iangej producing allT is sM
rsellh of Qfth g for s lr .
Rahn s 1tR a m r14r;+j b 1 f �cliGate an �`r'r lun'a re-r ira The new a r7r kwillh Ih bus i e.lfif 5 rain _
DISCLAIMER
r1,HRl aloe*notendorse the prnd KS)listed rart tens CertlflCete bnd makj, tou rupresertetions-warran( -or guarantees as to ind. ssuroroe no reswnslbJGty far,
the prole:l(s�Meted-On this.Ce:rtifteate,AHRI expo I}'d'isckeien&all lirablldty for damages W any kind arisfnff out of the w�v or peif ritmance of the pmduot(sa w lbtr
unauth-Drirq�-d-i%tcratian oT Oita,llsted on this'C�erldric;kc-Ccrtlfled *tinip are valid only for r We15 and eorrfig=fians Usted in the
allt"tzkry at wawo—a h rid Ire ctory,or�..
TEI;W AND CONDITIONS
This Cer^,r;Ficzi4c and its conkmts are pm-prr+c[aryr pyodrim of A!'rRr_7hr5 Ccrtlfuc3tts shalP only,'be used toT endaved5arl,peror7e:l and
.:
QDnftentlal rp0m.nce.purjf3*;cs,.The contints of ttkls Certdf sate may not,in v Mole ear in part, be reprodu d:c-aprr,d.dJsserrlmaiCcd;
antered into 3 carnputer'dat3b(nKw;or otherwi,*G Liallzed,In pny corm of masnffisror by any meaT+s,extept for the user',,indluldua1,
personal;ind oonft-derAW acfewence. AR-CONafT1tD ING,HEATING,
CERTIFICATE VERIFICATION �k'€FRIGE A71111 d 1115TFrUTE
'Me informatiion for the model- itl rW on this ceffifliCdtir;oan b&'.•t_rifbGd at wtirw_ahri+ keet€rry.ar�g, ctIck on'%;L!r;i Certifreatc" link SQL m.,l r Idle. Lie i_'r"
and eater 04�A,HRI Cer#ifiod Re'ferenca t'lrarnb€T and khc-date on whirr fly csrtltitMr ors lined,
whir, h is lested Ak ov-r, and the Cer',+ficate No-, -high Is Ilsted�#4ottom right. i
018Aif-Conditioning, Heating. and Refrigeration institute ! CERTIFICATE NO.: