HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04 PIT Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: %0-00 ��L=-�r0 }
Property Tax ID #: 0 40 21 �D f a1` 8 TP i�'
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
ti
i( Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors
Electric Plumbing _ Sprinklers _ Generator , Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 't-330 Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name LN—F�ttA1J _M696 Name:
) LlI
TRACY D STEELS AIR CONDITIONING INC
Address: Company:
City: �-,9_3S C Stater Address: 2750 SW EDGARCE ST
Zip Code: c�' �- Fax: City: PORT ST LUCIE State:FL
Phone No. "7 - Zip Code: 34953 Fax:
E -Mail
Phone No772-215-1974
Fill in fee simple Title Holder on next page (if different E-Mailtdsac@aoi.com
from the Owner listed above)
State or County License CAC035553
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 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 instanauut1 as Inuicate..
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 RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE REC0RDING YOUR N TICE OF COMMENCEMENT."
Signature of Owner) ess el ontractor as Agent for Owner Signature of C tra or icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The for�g�ooing instrument was acknowledged before me
this day of I� 2D by this&. day of A-? 261q by
TRACY D STEELE TRACY D STEELE
Name of person making statement. Name of person making statement.
Personally known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commissi e Com iss1 o. eal)
o ry u 1C tate of Florida o ary a he tate of Florida
Daniel F Stacey Daniel F Stacey
Expires 081 212022 M1�� Expires 08!22!2 22
REVIEW PERVISOR PL L MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REV W REVIEW
DATE
RECEIVED
DATE
COMPLETED
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certifier! Reference Number: 8242074 Date: 2/2712017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: GSX160181F*
Indoor Unit Model Number: ASPT25B14A''
Manufacturer: GOODMAN MANUFACTURING CO., LP.
Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR
CONDITIONING AND HEATING; ENERGI AIR; FRANKLIN
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, WI, WY, U.S. Territories)
Region Note. Centrai 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: GSX16
Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP.
Rated as follows in accordance with AHRI Standard 2101240-2008 for Unitary Air -Conditioning and Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 18000
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 18.00
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 products) 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 Gertitteate. Certified ratings are valid only for models and configurations listed in the
directory at www.ahridlrectery.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate snail only be used for individual, personal andAM
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, AIR-CONDITIONING, HEATING,
personal and confidential reference. & REFRIGERATION INST17tiTE
CERTIFICATE VERIFICATION
The information for the model Cited on this certificate can be verified at www.ahridirectory.org, click on "verify Certificate" link wv make life berwr^
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,i
which is listed above, and the Certificate No., which is listed at bottom right 1 3 1 32703389981 2507
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: