HomeMy WebLinkAboutPepperlane Clubhouse Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/02/2020
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial /. Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:MECHANICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 100 PEPPER LANE JENSEN BEACH, FL 34957
Property Tax ID q: 4511-503-0005-000-0
Lot No.
Site Plan Name:
y� Block No.
Project Name: Pepper (s ue o b h tuse
DETAILED DESCRIPTION OF WORK:
REPLACE A/C EQUIPMENT LIKE FOR LIKE CHANGE OUT
A4AC4036A1000 / A4AH4P36A 3 TON 14 SEER 5 KW
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4680.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NamePEPPERLANE CLUBHOUSE
Name:TIMOTHY WOJCIESZAK
Address-100 PEPPER LANE
Company: KRAUSS & CRANE INC
City: JENSEN BEACH State: _
Zip Code: 34957 Fax:
Phone No.914-500-5396
Address:904 SE DIXIE HWY
City: STUART State: FL
Zip Code: 34994 Fax: 772-283-4055
Phone N0772-287-1227
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailADMIN@KCIAC.COM
State or County License OAC1818726
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
UPPLEMENTAL CONSTRUCTION LIEN LAW INF RMATION:
)ES;IGNER/ENGINEER: Not Applicable �TGAGE COMPANY: Not Applicable
: me:
ss: A dress: State: CitState:
Phon Zip: P ne:
FEE SIMPLE TITLE HOLDER: _ Not Appicable BONDING COMPAN _ of Applicable
Name: Name:
Address: Address:
City: ity:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 your Notice of Commencement.
Signature of OwnV Lessee/Cofitractor a Agent for Owner
Signature of Conlr#tor/Licenile Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF mod+ o COUNTY OF
Swgrn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this_dayof_J(AyX�,2020 by
`riimtxt d Wb
Name of person making stgtefnent.
Personally Known OR Produced Identification
Type Identification —
Pr uc
(Wnature of N tary P c- State of Florida)
Commission No. (961 -lv.q5 (Seal),
S�qrn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day of �(V-- 2020 by
I )MyJ41t! Woesw
Name of person makin s ateme t.
Personally Known OR Produced Identification
Type of Identification
Produce �.
(Signature of NotatyEuXVState of Florida )
Commission No x5.4/s (Seat)
REVIEWS FRONT ZOWING SId,RERViSSCI - PLANS
COUNTER REVIEW RFVIEW-^ REVIEW
VEGETATION SEAiURT,E_ 14VLANGRO
REVIEW REVIEW REVIEW
Certificate of Product Ratin
AHRI Certified Reference Number: 204598673 Date: 06-03-2020 Model Status: Active
AHRI Type: RCU-A-CB
Outdoor Unit Brand Name: RUNTRU
Outdoor Unit Model Number (Condenser or Single Package) : A4AC4036A1
Indoor Unit Model Number (Evaporator and/or Air Handler); A4AH4P36A1B3
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, 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 RUNTRU 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 (95F), btuh : 33200
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 12.20
t"Active Model Status are Nose 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.
RatiMe that are for by WAS indicate an involuntary re -rate The new Published mling Is shown alord with the previous (i.e. WAS) rating.
DISCLAIMER
AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the products) 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.ahrldlrectory.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 users Individual, MIN
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 „c ,nake hf: kaw-
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.-
02020Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 132356664296209461