HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MIISY BE COMPLETED FOR APPLICATION TO BE ACCEPTED
%q, jZ-i Permit Number:
Date: 1
Building Permit Application
Planning and Development services
Building and Code Regulatl n Pivision
2300WrginlaAvenue,Fortpierce FL34982 Residential X _
Phone; (772) 462-1553 Fax: (772) 462-1578 Commercial ' _
PERMIT APPLICATION FOR: Mechanical
Address:
Legal Description: J_
Property Tax ID #:
Site Plan Name:/
Project Name: GO r
Setbacks Front__-__
—J� ti N.So N
Back: Right Side:
LIKE FOR LIKE AIC C{•1ANGEOUT q � o lv
Left Side:
trona wor<to e e ormme -undertnispermit - uim—all Shutters
HVAC � (las Tank ❑Gas Piping LJ
p
Electric Iwnbing
OS rinklers 0—Generator
Q �
Sq.
Total Sq. Ft of Constructior5;/-
Ft. of First Floor; —
Cost of Construction: $lYL t.�.___ �e 00 Utilities: LJ Sewer OSeptic
Address:A
U6, Ne,rTCity: ;
Applicable
MORTGAGECOMPANY:
Not Applicable
R/ENGINEER:
_Not
Name:
Address:
State:,__
State: _
'City:
Phone:_
Phone:Ilcable
Zip:
F�R;
Not App
BONDING COMPANY:
____Not Applicable
LE TITLE HOLDER:
_
Name:
Address::
Clty:
Zip: Phone:
Phone: ---
I certify that no work or installation has commenced prior to the issuance of a Permit-
nit
applicable Home Owners Assoc atron rules, bylaws or and covenants that may restrict or prohibit such
St. Lucle County,makes no representation that is granting a permit will authorize the permit holder to build the restrict
orsubject prohibit
structure
which Is in can let with any pp
ciation and review your deed for any restrictions which may apply.
structure. Please consult with your Home Owners Asso
in ain ccordance with the nsideration of the approved f this
plans,the Floe da Building I I Codees and SteLucle Counity Amendmeentsperformthe work
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sig s, 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 paon the ying twice for
improvements to your property. A Notice of Commencemenconsult
ons I ustbwi hcle deer or ad and p attodr ey before
before the first inspection. If you intend to obtain financing,
commeenccii�n work or recordin our Notice of Commencement
(it/L� _ s
r Owner
Signature of Owner/Lessee/Contractor as gent to
Signature of Contractor/License Halder
STATE OF FLORIDA
STATE OF FLORIDA COUNTY OF STciE
COUNTY OF ST LuciE
The forgoing instrumentwa� acknowledged�efore me
The for Ding instr nt vias acknowledged before me this J -0 -day of 20 by
this l day of Ir —' 20. Jby
CHRIS LANGEL
CHRIS LANGEL j- _ (Name of person acknowledging)
(Name of person acknowledging) ^ A /\ r ' /1 ^ /14)
y �
nature of Notary Public -State of Florida(S nature of Notary Public- State of Florida
( ) x OR Produced Identification
Personally Known
morally Known x OR Produced Identification Type of Identification Pr
Type of Identification Prod jU6TINAI NOp UNS•CONNELLY L7z JUb MINA �I�r 4QIdSCONNE Ly
WSSiGN#FF94i411 Commission No, FFsata ?*` - MyDpM USu YFF941411
FFaarart =*i MY Dec ember 6, 2019 kRiRES: December 0, 2019
Commission No. EX ._.
Revised 07/15/2014
REVIEWS C� ONTER RON[N=SUPERVISOR
REjJVIEGETATIO
EVIEWN S REVIEW LE MREVIEWVE
INITIALS
AU �l CERTIFIED"
www.ahridirectory.org
AHRI Certified Reference Number: 201924711
Date: 04-12-2019 Model status: Active
AHRI Type: RCU-A-CB
Series: DAVE LENNOX SIGNATURE XC25 SERIES
Outdoor Unit Brand Name: LENNOX
Outdoor Unit Model Number (Condenser or Single Package) : XC25-048-230-**
Indoor Unit Model Number (Evaporator and/or Air Handler) : CBA38MV-048-230*+TDR
Region: MTI NC, ND, NE, H, NJ,
CO�CNV, NY, OH, OK, OR, PA, RI, I CI SD, TN, X UTI VA, VT, WAMWV, WI MO. MS.
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.
1"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 OUT is still
own alon with the revious i.e. WAS rating
sellingr offe
Or for sale.
R. s that are accom anted b WAS indicate an involunta re -rale. The new ubiished ratio is sh.
DISCLAIMERtees as or the
the product(s) endorsisted e the this Certificate.product(s),
(AHRI exprlesslyrdisclaimstall liability for damagesofany kindarisingout of the use or performance ofand assume, theprrodu t(s)Y or,
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only formodels and configurations listed in the
directory at www.alirldlrectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, copied;
personal and mm
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; heus disseminated;
AIR-CONDITIONING, HEATING,
entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individua , & REFRIGERATION INSTITUTE
personal and confidential reference.
CERTIFICATE VERIFICATION we make life better -
The Information for the model cited on tills certificate can be verified at www.alirldirectOry.org, click on Verify Certificate link
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. M�;�„�����,.�� NO.:
� 131995432077498847
02019Air-Conditioning, Heating, and Refrigeration Institute