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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 • �z•� Date: 0,112_920 Permit Numbe RE `0 FE 7 '� N 10 Ewm D JAN 3 0 2020 Building Permit Application Planning and Development Services Permitting department Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVE MENT=LOCATION Address: 16 LAKE VISTA TRIAL UNIT 105 Legal Description: Property Tax ID#: 3422-500-0215-000-0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION. OF WORK: LIKE FOR LIKE A/C CHANGE OUT 2 TON A/H MODEL# FEM4P2400AL 14 SEER CONDENSER MODEL# NXA424GKC 5 KW HEATER CONSTRUCTION INFORMATION: Additional work to be nertorme un ert is permit–c ec all that appy: ❑✓ HVAC Gas Tank Gas Piping _Shutters Windows/Doors 1-1 ❑ p g ❑ Electric 0 Plumbing ❑Sprinklers E Generator E Roof Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$ 2,200.00 Utilities:cnSewer Septic Building Height: OWNER/LESSEE: J..' ,CONTRACTOR: Name STACEY L OUSLEY Name: Address: 1329 E HIGH ST Company: UNICO AIR CONDITIONING COMPANY City: JEFFERSON CITY State: MO Address: Zip Code: 65101 Fax: City: State:FL Phone No. 772-249-9100 Zip Code: 34997 Fax: 772-647-7544 E-Mail: Phone No. 305-528-1392 Fill in fee simple Title Holder on next page(if different E-Mail: marty@unicohvac.com from the Owner listed above) State or County License: CAC1814920 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTALCONSTRUCTION LIEN.LAW INFORMATION: . I DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable N a me:STACEY L OUSLEY Name: Address:16 LAKE VISTA TRIAL UNIT 105 Address: 1329E HIGH ST City: JEFFERSON 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 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. S'-�nc�A L. leq rro—L Signature of Owner/Lessee/Contractor as Agent for Owner Signature of acto Hol er STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Martin County COUNTY OF Martin County The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 29 day of Jan 20_ by this 29 day of Jan 20_ by Stacey L Ousley Oscar A Calzadilia 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 Nota - ori (Signature of Not ublic-State of Florida) PU!., TA M.A..GUIRR COmmIS510n NO. GG 1913 _■ :*c My C tVP1Mal$41C`v i �i 191327 1 GG 191 EiKE Maich ,2t1^2 Commission No. p ,,.-( ,4, fv1A. AGUIRRE Bonded Thru Notary Publx Uncicrwri:^rs I;a _ Ml COMMISSION#L�G 191327 EXPIRES:March ?r••' Borded Thru Netar Pubiic Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION S�A�'Tl�RS`C�` COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 CERTIFIED'rilial anal 1 Certificate of Product Ratings AHRI Certified Reference Number:9487261 Date:06-17-2019 Model Status:Active AHRI Type:RCU-A-CB Series:14 SEER N SERIES R410A AC Outdoor Unit Brand Name:TEMPSTAR Outdoor Unit Model Number (Condenser or Single Package):NXA424(A,G)KC— Indoor Unit Model Number(Evaporator and/or Air Handler):FEM4P24**AL 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 TEMPSTAR;product is responsible"for the rating of this=system combination t I Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda.l.and 2,Performance.Rating of Unitary AlrConditionmg&Air`-Source Heat Pump Equipment and subject to rating accuracy by AHRI sponsored Independent third party testing l Coolmg'Capaclty(A2) Single or High Stage(95F) btuh:22800 SEER';14.00 EER A2 -Single or High Sta e.95F :11.50 II ; 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. RatiNgs that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the orevious(i.e.WAS)ratina. 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;CDNDff ZONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridlrectory.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. 132052876240255052 ©2019Air-Conditioning,Heating,and Refrigeration Institute RTIFICATE NO.: - ::CE '"