HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential X
PERMITTYPE: HVAC - AC CHANGE OUT
PROPOSED IMPROVEMENT LOCATION:
Address: 1310 Nettles Blvd, Jensen Beach FL 34957
Property Tax ID #: 4502-501-1497-000-8
Site Plan Name:
Project Name- Finch
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
EXACT AC CHANGE OUT OF 3 TON- 14 SEER- 10 KW HEATER- PACKAGE UNIT LOCATED OUTDOORS.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric — Plumbing Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 424 Sq. Ft. of First Floor:
Cost of Construction: $ 3600 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Roger Finch
Name: Douglas Pence
I
Address: 1310 Nettles Blvd
Company: Absolutely Cool A/C LLC
City: Jensen Beach State:
Zip Code: 34957 Fax: n/a
Phone No. 561-688-6336
Address: 2311 NE 15th Court
City: Jensen Beach State: FL
Zip Code: 34957 Fax: nla
Phone No 772-475-4641
E-Mail: r-finch@comcast.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail absolutelycoolair@gmaii.com
State or County License CAC1815702
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 MEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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 RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signkure o, C%ntrandr/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF V +i 4A'V--�
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this � day of i 20 ice' by
Name of person making statement.
Name of persoyi making statement.
Personally Known OR Produced identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(tignatu;e;of Na`tary Publ' , t� ricn " `c
{ an Les Bradford
244808
s MY GOmrnission GG
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Commission No. (Seal) Seal
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Commission No. h.. ''5 � raro1r2o2x
REVIEWS
FRONT
ZONfNG
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
Certificate of Product Retinas
AHRI Certified Reference Number: 202356657 Date: 07-09-2019 Model Status : Active
AHRI Type; SP-A
Series. LX SERIES
Outdoor Unit Brand Name: YORK
Outdoor Unit Model Number (Condenser or Single Package) : PCE4A3622"
Region :All
Region Note : 1803
The manufacturer of this YORK product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSIIAHRI 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:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 35200
SEER, 14.00
EER (A2) - Single or High Stage (95F) : 11.20
t"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.
Ratin s that are accom anied bv WAS indicate an involunla re -rate. The newpublished ratin is shown alon with the previous i.e. WAS ratin
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;
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-CONDFTIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahridirectery.org, click on "Verify Certificate" link we make life 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.
02019Air-Conditioning, Heating, and Refrigeration Institute 1 CERTIFICATE NO.: 132071679344172138