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HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 9 [ Permit Number:. n s Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-3578 PERMIT TYPE: Building Remit Application PROPOSED IMPROVEMENT LOCATION: Address: Property Tax 1D #: Site Plan Name: Project Name: Commercial Residential �.4 W /.LW_Nlp;1Ms.*��jr�[ + DETAILED DESCRIPTION OF WORK: tt CONSTRUCTION INFORMATION: V Additional work to be performed under this permit—check all that apply: Mechanical Cas Tank — Gas Piping _ Shutters Electric _ Plumbing Sprinklers _ Generator Total Sq. Ft of Construction:: `p Sq. Ft. of First Floor: _ Cost of Construction: $ W Lot No. 73 Block No. NdF7rX Windows/Doors Roof Pitch Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 6-h% itA4 c 16 Name:lG [ Address: P �9 Company: City: 0'1- U'C"r State: _ Zip Code: `+ Fax: Phone No. 17 ° Y - Oco E -Mail: I/b&ZjEMf.moi(.= C Address: ;Yn 5W e City: State: Zip Code: WWO Fax: Phone No �% ' %/l 7 Fill in fee simple Title Bolder on next page ( if different from the Owner listed above) E-MailW"1 r+M- 13WYbu l-1 State or County License b l-3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION: DESIGN ER/ENG [NEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: i FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Address: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 1 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 JOJB SITE BEFORE THE ¢IRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENPFA OWAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C_nMMFNCFMFNT_" ev. lal,14 Signature of Owner/ Lessee/Can t s gent for Owner Signature of Contractor/Liven r STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The foAgoing instrumant was acknowledge before me The far Ding instrum nt was acknowledgeefore me this day of LST 20by this day of L , 20 by ' �- Name of person mailing statement. Name of person making statement. Personally Known OR Produced identification Personally Known OR Produced Identification Type of ldentifica ion f Identification Produced " TIFFANYCATRINI Prod ed "° 7IFFANYCAfRINI *: Commission # GG 1$5159 Expires February 13, 2022 : Commission # GG 1$515 Banded i}uuTwyFain lnsurance 4W700'TP6`GPPa= Expires February 13,20 �, f CLQ „ . Randal Thm Tray Fal" Inum of otary Public- State o ori a) (SigTs—��cno. (Sig t , f N ary Public- Sta e of Florida } Com(Sea[j Comr ss' n No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Certificate of Product Ratings AHRI Certified Reference Number: 201907216 Date :09-09-2019 Model Status : Active AHRI Type: RCU-A-CB Series: DAVE LENNOX SIGNATURE XC21 SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : XC211-060-230-11 Indoor Unit Model Number (Evaporator and/or Air Handier) : CBA38MV-048-230*+TDR Region: Ali (AK, AL, AR, AZ, CA, CO, CT, DC, DF, 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, SO, TN, TX, UT, VA, 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 LENNOX product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 2101240 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 : 57000 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 12.15 -"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; C)R 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 accam anied by WAS indicate an involuntary re -rate. The new eublished rating is shown along with, the previous i.e. WAS rating. 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 filon This Certificate and Its contents are proprietary products of AHRI. This Certificate shah 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, Arw personal and confidential reference. AIR-CON017110NINCv, HFJyTING, & REFRIGERATION iNs7 ri-rrE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link w�-, crake life berter' 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. 1321252588©9567457 @2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: i Ilk AN worf, M Client Name: rt Address: Phone Replacen Brand: Tonnage: SEER: Warranty: Parts: $ Additional investments: Add Supply Duct W/Grille Labor: 355.84 Sub Total: Addith Attic/Ceiling Mount Air Handler $ 490.50 10 Year Labor Warranty $ 1,360.32 5 Year Labor Warranty $ 819.68 Re -Surface Air Handler Stand $ 201..65 Re -insulate Air Handler Stand $ 160.04 Replace Disconnect Switch $ i8`3.49 Add Disconnect Switch $ 231.47 Add Electrical Whip $ 102.56 T-Stat (Non -Programmable) $ 120,40 T-Stat (Programmable) $ 170.93 Re-route Drain Line ( upto 25') $ 138.96 Condensate Pump W/ Line $ 582.06 Replace Condensate Pump $ 422.33 Replace Supply Plenum $ 356.25 Replace Return Plenum $ 356.25 Replace Both Plenums $ 638.74 Seal Entire Duct System $ 712,83 Filter Rack $ 156.94 Surge Protcetor $ 372.78 Additional Materials Deeded: www.honestairinc.com PH: 772-232-1114 FAX:772-232-1118 Email: Date: C.A. ient5 $ Additional investments: Add Supply Duct W/Grille $ 355.84 Sub Total: Add Return Duct W/ Grille $ 355.84 Thru The Wall (by pass) Grille $ 288.85 Line Voltage Wire (upto 25') $ 219.90 Low Voltage Wire (upto 25') $ 183.68 Condenser Pad $ 228.80 Crane Service $ 490.50 Replace Refrigerant Line Set $ 1,074.35 2 Preventative Maint. $ 138.00 Gas Pipe Extension $ 86.20 Indoor Air Quality Products PMAC Air Cleaner $ 870.91 UV Complete $ 1,142.67 UV Dual Bulb $ 1,016.58 UV Coil Scrubber $ 692.78 Oxine Duct Sanitizer $ ,_354.25 - Equipment Total: $ Additional investments: $ Totall.A.Q, $ Sub Total: $ By signing this contract you are entering into a binding agreement Total investment: between yourself and Honest Air, int. The amount stated in "tots! 1 f fsdei. investment" is the amount to be paid upon completion of the Total investment includes: Taxes, Permit, Breakers, Installation, work described above. Failure to pay the full amount will result in removal Disposal of existing equipment, labor, and all additional items listed. of equipment and any fees associated with such:work as well as any legal fees. Date: -- I, the Client, agree to pay the full amount stated for the: work described.above. Date: I, the Comfort Advisor, agree to oversee.th�'work stated above.and to insure proper installation thereof.