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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: J 0 Building Permit Application Planning and Development Services building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 462-1579 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Legal Description. Property Tax ID #: - ^1 _ Lot No.� Site Plan Name: Block No._ Project Name:(, ,44-, - Setbacks Front Back: Right Side: Left Side: Replace AC, exact change out with a.c4on, SEER, mitionai worK to De errormea unaer tors permit - ci 13HVAC Gas Tank aGas Piping 11 Electric 0 Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ L_ , M- a "Shutters CGenerator KW AC unit S Ft. of First Floor: _ Utilities:USewer Septic Windows/Doors 0 Roof Roof pitch Building Height: OWNERAESSEE: CONTRACTOR: Namelc-&e �_ Name: Dennis Zacek Address{' 1(p y Company: AIRS American Residential Services City: t State Address: 2800 US Hwy 1 Zip Code: Fax: -� City: Vero Beach State: FL Phone No. Zip Code: 32960 Fax: E-Mail: PhoneNo. •� a �j Fill in fee simple Title Holder on next page (if different E-Mail: iy:5o\ ,O&A0'yS • CO`M from the Owner listed above) State or County License: CMC1249753 It value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work_ or recording your Notice of Commencement. Signature of O er/ Lessee/Agent Signature of Contra r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 51Lucie COUNTY OF StLma The foroing instr ent wa knowledgeAefore me this day of 20 by The o� Ding instr ent was a now ledgeefore me this day of L)2f] 6y gnnis Z k Dennis Ze /1 { me f person a owle g g } { me person acknD fed ing } ig of ry ubl - a Florida }to of ida j Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of identification Produced Type of Identification Produced Commission No {seal} I Commission No. (Seal) COLS N SULLIVANI Revised 07/ 15/2U 14 Ah MY COMMISSION # GG071535 T =�,�?•a '= MY COMMISSION # GG071535 . EXPIRES February 09. 2021 EXPIRES February 09, 2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATLIRTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Certificate of Product Ratinas AHRI Certified Reference Number: 9489533 Date: 08-14-2019 Model Status: Active AHRI Type: RCU-A-CB Series: 14 SEER AC Outdoor Unit Brand Name: PAYNE HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package),. PA14NC030'0'"A' Indoor Unit Model Number (Evaporator andlor Air Handler) : FB4CNF030L Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, WI, 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 PAYNE HEATING AND COOLING product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210l240 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), bluh - 28200 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 12.00 t"Active" Model Status are those that an AHRI Certifir atlon Program Parr :pant is; curwritly producing AND selling or offering for sale; OR new models that are being marketed but are not yet being produced'Product on Stopped` Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale Ratings That are ac=ampanied by WA5 ind ;:.auto an it uluntary re -rate. The new published ral,no is shown along with tho previous fi.e. WASI ralina. 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 products) 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.ahildirectory.org. TERMS AND CONDITIONS contents This Certificate and Its conteto nts 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.coNDmoNINo, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link ur m.rkr IiIN hrttcr'• 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. - ©2019Air-Condition ing, Heating, and Refrigeration Institute CERTIFICATE NO.: 132102898631697368