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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 81 IOl cz
•
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: NAC
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential
Address: &W e!Q%u Cam( -[jrt4 PSL F1- 34gsa
Property Tax ID #: 3405 7w co 89 oo9 Lot No. i
Site Plan Name: Block No. )Z
Project Name: Sfr)-14h AC. r,i'� o(JA
A FVX I -0 -7,i q,a q )4
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 3a,ro Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name `\iAAlmnrlj SihAls
Name: a
Address: 3110o C(CIhLt?UDG( 100-
Company: I
^
City: i� '<1- State: FL_
Zip Code: 34g5c� Fax: oIA
Phone No. 77j - 343 ` 0-1(P 3
Address: 9(A)4k fkh
City: �s`ULL(i' State:__R,
Zip Code: 54 fq-7 Fax: nl4
Phone No how- i1siI�
E-Mail: CatA and �r_�0 Qma� l • Wrn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail hf3lt (Ytz
,
CLCA.( iy,: Cti/ -Loitl
State or County Licensee C 651 la is
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: )0- Not Applicable
MORTGAGE COMPANY: __)o Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _}_oNot 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 BY YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE ORE -THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDEROR AM ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Si nat re of OwnerLy ee/Contractor as Agent for Owner
Signature of Contra or/license Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF (` W-i3n
COUNTY OF /YYatl�ill
The forgoing instru ent was acknowledged before me
The forgoing instrument was acknowledged before me
this_]QdayofJ(1t11 .20&2by
this17,dayof,20_6LOby
`
OUArii dna{ �v�
1��
Name dqerson making statement.
Name of person makin statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced a)L..,
Produced
(Signature of Notary Publi
Commission No. 3ii
STat F crl abNIEL ENGLAND
:.y, ,; Notary Public State of Florida
;. Y ; •' C ion r GG 333870
pppp��g9��
= My Cd I.TDires May 13. 20Z3
(Signature of Notary Publi
Commission No. i3)O
$ FlorldacIANIEL ENGLAND
„�. ; Notary Public State of Florida
Co GG 713870
---"vC. `` �r�a9)yZ55yyppn�
...,rr. My CoMB'F4kpves May tl. ZOZ3
8arded thrxvh Nationa. sotary Avr.
Sorded through National Notary ASV.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
key. 2/7/19
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Certificate of Product Ratin
AHRI Certified Reference Number: 7492914 Date: 06-12-2020 Model Status: Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Series: R410A AC SPP
Outdoor Unit Brand Name: ICP COMMERCIAL
Outdoor Unit Model Number (Condenser or Single Package) : PAJ448000K—OA
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 priorto January 1, 2015 are eligible to be installed in all regions
until June 30, 2016. Beginning July 1, 2016 central air conditioners ran only be installed in region(s) for
which they meet the regional efficiency requirement.
The manufacturer of this ICP COMMERCIAL product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSUAHRI 210240 with Addenda 1 and 2, Performance Rating of Unitary
Air-conditioning 8 Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (9517, bluh : 47000
SEER: 14.00
EER (A2) - Single or High Stage (91 : 11.50
?'Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering ror 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 ism longer producing BUT is still
selling or offering for sale.
Retinas that are accompanied W WAS indicate an involuntary re -rate. The new published ratiro is shown alona with the previous fie. WASI rating.
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees ax to, and assumes no responsibility for,
the product(s) listed on this Grtificete. AHRI expressly disclaims all liability far damages of any kind arising out of the use or performance of the preducl(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are slid only for models and configurations listed in the
directory at www.ahridltectory.org.
TERMS AND CONDITIONS
This Certificate and Its center are proprietary pratlue6 of AHRI. This Certiflcete shell 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, PJM
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION a REFRIGERATION INSTITUTE
The information forthe model cited on this certificate can bevertfied at www.ahtidirectory.ors, click an'Vedty CertlHcate-link ire ineko life hotter'
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 rift 132417241023065226
©2020Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: