HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
a
Planning and Developmentservices
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1-578
Property Tax ID #:
Site Plan Name: f"t
CONSTRUCTION INFORMATION:
Permit lumber:
s
Commercial Residential,
Additional work to be perforated under this permit --check all that apply:
Mechanical ^ Gas Tank Gas Piping —Shutters
— Electric _ Plumbing , Sprinklers Generator
TOtaI Sq. Ft of Construction:
Sq. Ft. of First Floor; _
Cost Of Construction: $ ��I' Utilities: ____ Sewer Septic
OWNER/LESSEE
City: kt±11- /I State: 61
Zip Code: -03a (p Fax:
Phone No.
E -Mail -
Fill in fee simple Title Holder on next: page (if different
from the Owner listed above)
CONTRACTOR:
Lot No_
Block No.
— Windows/Doors
Roof Pitch
Building Height:
Name: OR
Company: l✓ r.C()
Address: 10KID rt 21 a
City: LJState: P
Zip Code:Fax:
Phone No J1 �, cc4c C�
E -Mail D
State or County License '� �'`�I C'1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of l-IUAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
UVVIVr-K/ LUN i RAC:I OR AFFIVVIT; 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
Signature of Owner/ Lessee/Contractor as Agent for owner
STATE OF FLORIDA
COUNTY O F PALM BEACH
The forgoing instrument was acknowledged before me
this '� day of: Ufl t° , 26 .
RORY RAMCHARAN
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- S
Signatur of C ractor/License Holder
STATE OF FLORIDA
COUNTY O F PALM BEACH
The forgoing instrument was acknowledged before me
this2& day o,—.Ttt)OLC ,20 Dy
RORY RAMCHARAN
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
nature of Notary Public- S t '
Notary Pubk State of FI
Commission No. FFg7U9G
.( ILLEAU-AMRAT C mission No. FF&I.70I I
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REVIEWS FRONT
ZONING SUPERVISOR PLANS VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW REVIEW REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
AHRI Certified Reference Number: 9487254 Date: 04-14-2020 Model Status : Prdduction Stopped
AHRI Type _ RCU A -CB
Series; 14 SEER N SERIES R41 OA 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 Handier): FMA4P24**A*
Region : Southeast and North IAL, 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 -
Rated as follows in accordance with the latest edition of ANSIIAHRI 2101240 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 ; 22800
SEER: 14.00
FER (A2) - 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 sale.
Ratings that are accompanied by WAS indicate an involuntary re -rate. The new _ublished ratin�pt is shown alonq 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 prodrlct(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 fasted 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-CONDITioNING, HEATING,
CERTIFICATE VERIFICATION
& REI;RIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.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 fisted at bottom right.
I
132313-58f3521312184
d202OAir-Conditioning, Heating, and Refrigeration Institute
CERTIFICATE N4_.