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HomeMy WebLinkAboutGillumPermitAppAll APPLI AB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '—tPermit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: PROPOSED IMPROVEMENT LOCATION: Address: 8845 Champions Way Port Saint Lucie, FI 34986 Property Tax ID #: 3334-501-0026-0001 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: 4.0 Ton Heat Pump Split System 10 KW Heat Like for Like Lot No.12 Block No. A I CONSTRUCTION INFORMATION: I 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: Cost of Construction: $ 8000 Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: Name Lonnie Gillum Address: 8845 Champions Way City: Port Saint Lucie State: In Zip Code: 34986 Fax: Phone No.772468-1022 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: Robert Marcelle Company: Comfort Experts USA Inc Address:664 NW Enterprise Dr. Unit 120 City: Port Saint Lucie State: FI Zip Code: 34986 Fax: 772-873-3090 Phone N0772-873-3000 E-Mail ckongerl4@gmail.com State or County Licens Fvalue of construction is $2500 or more. a RECORDED Notice of Commencement is reauired If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ 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 JOB SFFE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' T� Signature o er/ Lessee/Contractor as Agent for Owner Signature of ntractor/License Holder STATE COUNTOYOFORIDA `11�1 OF ORIDA,I �� Qacckn(o�wledpo COUNTYOFSTATE The forgoing instrument was d before me The forgoing instrument was acknowledged before me this 5 day of February , 2iYD by this 5 day of February 2ZO by R n -y ff arce%e &W1 MCI rce([e Name of person making ame of person mak MY"',,tjnC[�CC{tJAAT(TH�F]ERINE MILLER Personal) Known r tery Public Y •0SI.VIIII iM `1'1 V„ CATHERINE MILLER ersonally Known ,z �,�g Public hhft i Type of Identification ;:� ddc` My Commission Expires P C"0rnl YPe of Identificatio g? My Commission Expires %,.e���, otivers license „a n,„c Produced November01.2022 bk ,: �r�o/lduced Gwers License ,,,,a� ,{'(Nq/ov�ember 07, 2022 - (Signature of Notary Public -State of Florida) (Signature of Notary Public- State of Florida ) Commission No. GG273315 (Seal) Commission No. GG273315 (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 Ratin AHRI Certified Reference Number: 202570610 Date; 02-06-2020 Model Status : Active AHRI Type: HRCU-A-CB Series: Merit ML14XP1 Series Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : ML14XP1-048-230A" Indoor Unit Model Number (Evaporator and/or Air Handier): CBA25UH-048-230--'* 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 AHRI 2101240 with Addendum 1, 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 : 47500 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 12.00 Heating Capacity (1-112) - Single or High Stage (47F) : 46000 HSPF (Region IV) : 8.20 f"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 offanng for sale. Retinas that are accompanied by WAS indicate an involunta ate T he new published ratina is shown alono with the previous (Le. 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.ahrldirectury.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, AM personal and confidential reference. AIRCONDRIONING, 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 bone 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 ©2020Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.. 182254677690207196 Permit No. State of Florida County of St. Lucie NOTICE OF COMMENCEMENT Tax Folio The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Owner information or Les a ipforrmion If the Lessee contracted for the improvement: Name l Wnl _���\�.11 Y1 Address SJ LA PAIII I Interest in property: DiLJJW Name and address of fee simple titleholder (if different from Owner listed above): Contractor's Contractor A Surety (if applicable, a copy of the payment bond is attached): Amount of bond: Name and address: Lender Name: _ Lenders address: Number: Phone number: Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Sec 713.13(1) (a)7., Florida Statutes: Name: Phone Number: Address: In addition to himself or herself, Owner designates Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes. Phone number of person or entity designated by owner: to receive a copy of the Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OFTHE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commence to the best of my knowledge and belief. = l.�V'.. CATHERINE MILLER y1 :° 4�=State of Florida -Notary Public D� ,-®_ Commission# GG 273315 j i n ure of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Pa hr$ 1MIger Y Commission Expires (fig November 07. 2022 (Signatory's Title/Office) //j The foregoing instrument was acknowledged before me this day pda/y of� , 20 Z A Y e � (�\Vtliri as I� XJI \CJT for me of Pelson Type of authority (e.g. officer, trustee) Party on behalf of whom i tr ment was executed Personally known_ or produced Identification . (Signature of Notary Public - State of Florida) i p� (Print, Type, or Stamp Commissioned Name of Notary Public) Type of Identification produced 3 Lf✓