HomeMy WebLinkAbout00313All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -
Ct3UNTY
r
L
o R l A A
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 TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential
1
Address:
Property Tax ID #: - 00 3 3 _ Lot No.
Site Plan Name: wy i r7 n « "," Block No.
Project Name: -"
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional ork to be performed under this permit- check all that apply:
1-, echanical _ 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: $ 2 50 , Utilities. , Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name A-- Name:
Address: Compan L
City: /t. State: L( Address: J t s r
Zip Code: / Fax: City: L r State:
Phone No. -2e Zip Code: _-5S Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail Z1l f in cd ,:s Lazy!
from the Owner listed above) State or County License"-f lec -� 7 5 V
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 CONSTRUCT10
DESIGNER/ENGINEER:
Name:
Address:
City:
zip — Phone
FEE SIMPLE 1 ITLE FIOL6ER:
Name;
Address:
City:
Zip: Phone -
BEN LAW INFORMATION:
)t Applicable MORTGAGE COMPANY:
Name:
�..� Address:
State: City:
zip: —..�� Phone:
of Applicable BONDING COMPANY:
Name:
Address:
city:
Zip: Phone:
Not Applicable
State:
Ot Applicable
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 Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horne 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 TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF RESULT IN YOUR PAYINGCOMMiF.1iiCEMENT MUST BE RECORDER AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN ANCING, CONSULT
WITH YOUR LENDER O AN ATT Y l�El'[DRE RIECOR DING YOUR NOTICE OF COMMEN ME
"
Signature of Owner
as Agent foAwner
STATE OF FLORIDA
COUNTY OF /?77`7
The for I Ing instrum nt was acknowledged before me
this 1 day of C �j a�
2pA'_�j by
Name of person m72OR
ment.
Personally Known Produced Identification
Type of Identification
of Nota�y Pub€ic- State of Florida j
,e ?u.SWCEr Pe:
tiotary aabiic State o+Florida
iln CGMMIWOP cGG 315a66
REV
LATER I REVIEW
RECEIVED
DATE
COMPLETED
Signature of Contract /License holder
STATE OF FLORIDA /
COUNTY OF rYjfj �f,/
The forgoing instr m gn was acknowledge before me
this day of U ;Ci z01� by
Name of person making stt ement.
Personally Known 1/ OR Produced Identification
Type of Identification
15ignture of Notary ublic- State of Florida )
Coto scion
1 :at'JTP6eG KELLIEJ SWHa
xf r.ota
•rY Pubiic -State of Frerie#a
v�`C5 i 5 rt - �
SUPERVISOR PLANS .�
EGET��I co `-Y�ires
�073
REVIEW REVIEW ssR. MANGROVE
REVIEW
.u�■�ICERTIFIED°
www.ahridireciory.orgCertificate of Product Ratinas
AHRI Certified Reference Number: 9193304 Date, 11-15-2019 Model Status : Active
AHRI Type: RCU-A-CB
Series: 14 SEER AC
Outdoor Unit Brand Name: CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : CA14NA030"0—A"
Indoor Unit Model Number (Evaporator and/or 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 CARRIER product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 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 (9517), btuh : 28200
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 12.00
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 by WAS indicate an involunta re -rate. The new ublished raft is shown aloe wiEh the revious 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
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and r" "IMP
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, 0" No al
Personal and confidential reference.
AIR-CONDITIONING, 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
and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we male life better -
which is listed above, and the Certificate No., which is listed at bottom right. --.
CO2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132183082839579126