HomeMy WebLinkAboutPermit Change out 03.17.2020 ahriAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial
PERMITTYPE: V C n g
PROPOSED IMPROVEMENT LOCAT
ION-,
Address:
I
L
Residential
� g
Property Tax ID #: � r' S� Q- MQ ,3 -J4Q - 3 _ _ Lot No. /
Site Plan Name: Block No_
Project Name: — ;dUed1C �-
j DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
e�echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric — Plumbing — Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction: 6? TS f T-� Sq. Ft. of First Floor:
Cost of Construction: $ 4<'o 0 0 - Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE •
CONTRACTOR. -
Name O
Name:
Address
—kLdhafus
Company: Q
City: Pot--+ C ► State: 1-�L-
Zip Code: Fax:
Phone No,,. (o / -- ag% ^ 6
Address: o Zp -6V //;1 _V1 0
Xj'�4 Bid
City:._. PO4:f`,O- LL)C- 2e- State: rk.
Zip Code: _ i 3 Fax:
Phone No 7 i22-- 6 at -26)S-6
E-Mail: �(�jD a.l�a.iC -��. C OWN
Fill in fee simple Title holder on next page (if different
from the Owner listed above)
E-Mail ► ce
State or County License
11 valuC V I f.u11,L1 ULUV" 1b �kL7Vu Or mere, a Kt4VKL tU IdOiice oT Lommencernent is requlrecl.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
Name:_
Address:
City:
Zip:
EER: Not Applica
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City: _
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name:_
Address.
City:
Zip: Phone:
UWNER/ 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 ermit 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, wails, signs, screen rooms and accessory uses to another non-residential use
"`'YARNING TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYEMENTS 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
Wri UR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_"
of owner/ Lessee/Contractor as Xgent for Owner
STATE OF FLORIDA
COUNTY OF 1 G L)C
The forgoing instrument was acknowledged before me
this.rd'day of 20-20by
5
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced bgld�
a�,
GINS
v° i
[gnature of N - - 91EM rofsNaridbgG 956362
:�� �?r My Commission Expires
_ F'
��" lebruary 9, Q24
Commission No.
Sig ure of n icense Holder
STATE OF FLORIDA _
COUNTY OF 11 L.VC
The forgoing instrument was acknowledged before me
this -/3- day of 1 { - _ , 20;20 by
-1-AMkP�N r►iir.t.iw
Name of person making statement
Personally Known lJ OR Produced Identification
Type of Identification
Produced
{Signature of Notary Pub
G� C� NoQtary Public -State of F
Commission No. _ *= iigission # GG 951
MyCommission Expi
r+yivavi: &--.12 F
SEATURTLE
REVIEWS~
FRONT
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SUPERVISOR
PLANS
VEGETATION
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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fli, L -31 1 1 [6-1 i1v IN!'11
AHRI Certified Reference Number: 202865074 Date : 03-13-2020 Model Status: Active
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name: RHEEM
Outdoor Unit Model Number (Condenser or Single Package) : RA1424BJ1
Indoor Unit Model Number (Evaporator and/or Air Handler) ; RH 1 P2417STAN
Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, All CO, CT, ID, IL,
IA, IN, KS, MA, ME, Ml, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, Rl, 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 RHEEM 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 -- 23400
SEER: 14.00
E>R (A2) - Single or High stage (95F) : 11.50
1"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 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(s1listed 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.ahriidirectory.org.
TERMS AND t+OI
This Certificate andd its its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and Sol
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; dlsseminated;
entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, Ar"M MIN
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified atwww.ahrid! reetory.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 - - --
02020M-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1=85K7131679465