HomeMy WebLinkAboutJacob permit appAll APPLICABLE I FO MUPT BE COMPLETED FOR APPLICATION TOQEACCEPTED
Date: Permit Number:
-- Building Perm;* Application
Planning and Development Services
Building and Code Regulation Division
23DDVirginia Avenue, Fort Pierce Fl34982
Phone: (772)4GI-1S53 Fax: (77Z)462-1578 COnlrnerCi@\Residential
PERMITTYPE:
LPROPUSED IMPROVEMENT LOCATION:
Project Name:
DETAILED DESCRIPTION OF WORK:
| CONSTRUCTION INFORMATION: �—|
Ad | rktobepe�onned under th�penn�—check aUthat app�:
7chanicai __ Gas Tank —Gas Piping Shutters
__Electric __Plumbing —Sprinklers Generator
Total Sq. FtofConstruction:
Cost ofConstruction - $
Sq. Ft. ufFirst Floor:
___
Utilities: —Sewer —Septic
___Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name W,
Name:
City:
State:
Address:
Phone No. q
Zip Code:
Phone No
Fax: 179
E-Mail:
Fill in fee simple Title Holder on next page if different
E-Mail.
from the Owner listed
above)
State or County License
�--------'_—~.~~... ..vk"� a ^~"°°r-"Vivuccpri_nmmmncementonequirau.
Ifvalue of*vAC is $7,50Vormore, nRECORDED Notice ofCommencement isrequired.
M
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applica
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:_
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:
Zip: Phone -
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR N A ORNEY EFORE RECORDING YOUR NOTICF�Q* COMMCNCEMEJ1$i."
Signature of
STATE OF FLORIDA
COUNTY OF //
Agent for Owner
The forgoi g instrumerItpas acknowledged before me
this_ZS day of / 20 a by
t' 7�Z.<�-t-f
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification
Produced
(Signature ovary Public -
Commission No .17:
REVIEWSIL
Banded
COUNTER
RECEIVED
DATE
COMPLETES}
P19102
REVIEW
Signature of Contractor/Licensq(X61`d"er
STATE OF FLORIDA
COUNTY OF �(J
The forgoing instrum as acknowledged before me
thisay of 20j by
Name of person making statement.
Personally Known OR Produced identification
Type of Identification
Produced
(Signature of Notary Pu
Commission No.
Expires October 2,
102
SOR I PLANS I VEGETATION SEA TURTLE MANGROVE
V I REVIEW I REVIEW REVIEW REVIEW
•�+:�■:�i CERTIFIED°
www.ahridirectory.orgCertificate of Product Ratinias
AHRI Certified Reference Number: 201298732 Date: 03-25-2020 Model Status : Active
Old AHRI Reference Number: 7984193
AHRI Type: RCU A -CB
Series: GSX14
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX140301 K*
Indoor Unit Model Number (Evaporator and/or Air Handler) : ARUF31 B14A*
Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, ILA, 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 priorto 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 GOODMAN product is responsible forthe rating of this system combination.
Rated as follows in accordance with the latest edition of ANS€!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 (95F), btuh : 28200
SEER: 14.00
EER 02) - Single or High Stage (95F) : 11.50
?"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 sate.
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 M
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-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 make fife better --
which is listed above, and the Certificate No., which is listed at bottom right.
0202OAir-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132295203477066520