HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APF LICATION TO BE ACCEPTED
Date: 11/23/2020
Permit Number:
S�o lua
a n Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Reside tial X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION: 6arage
Address: 5365 San Benedetto PI
Property Tax I D#: 1311-701-0024-000-4 17
Lot No.
Site Plan Name: Waterstone Phase Two
Project Name: Christopher Gay Block No. 5
DETAILED DESCRIPTION OF WORK:
Install New Mitsubishi 1 ton Mini Split in the garage
MUZ-GL12NA-U 1
MSZ-GL12NA-Ul
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
'yt Mechanical _Gas Tank —Gas Piping —Shutters Windows/Doors _Pond
Electric —Plumbing —Sprinklers: —Generator _Roof Pitch
Total Sq. Ft of Construction: I Sq. Ft. of First Floor:
Cost of Construction: $ 3600.00 Utilities: `Sewer Septic Bui ding Height:
OWNER/LESSEE: CONTRACTOR:
Name Adams Homes Of Northwest Florida Inc Name:Samuel T Durham
Address:3000 Gulf Breeze Pkwy Company:Advantage AC of the TC
City: Gulf Breeze State: 'PL Address:601 S Market Ave
Zip Code: 32563 Fax: City: Ft Pierce State:FU
Phone No, Zip Code: 34982 F x: 772-465-4945
E-Mail: Phone N0772-465-1606
Fill in fee simple Title Holder on next page(if different E-MailAdvantagepermits@hotmalf.com
from the Owner listed above) ! State or County License CACO 9664
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.
I
SUPPLEMENTAL CONSTRUCTION LIEN LA W INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: ^Not 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 w rk 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 restrictio s which may apply,
Inconsideration of the granting of this requested permit,I do hereby agree that I will,in all respects, erform 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 t obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of tornmencement.
F
Signature of Owner/Lessee/Contractor as Agent for Owner- Signature of Contractor/License H Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
n to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscri ed before me of 0* °r
Physical Presence or Online Notarization x Physical Presence or nline Notarization
h 23 day of November 12020 by this 23 day of November 2020 by
a
Sa el T Durham Samuel T Durham
a e of person making statement. Name of person making statement �.
j:
nally Known x OR Produced Identification Personally Known x OR Proi luced Identification
of Identification Type of Identificatio ! h
' uced Produced12
w q
Ni
(Si nature of N6t2Ly P - of Florida) (Signature o Pub tote f Florida
mission No. G0263239 (Seal) Commission No. GG263239 (Seal)
REVIEWS FRONT ZONING SUPERVISbR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW i REVIEW REVIEW R VIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
This cgmbination qualifies for a Federal Energy Efficiency Tax Credit when
* r placed in service between 1/1/2015 and 1213 12020.
ctory.r rg
Certificate of Pr duct Rating�
AHRI Certified Reference Number:201754311 Dote:11-23-2020 Model Status:Pro uction Stopped
AHRI Type:HRCU-A-CB-O(Mini-Split Heat Pump,with Remotq Outdoor Unit Air-Source,Free Delivery)
Series Name:M-Series
Outdoor Unit Brand Name:Mitsubishi Electric
Outdoor Unit Model Number:MUZ-GL12NA-Ul
Indoor Type:Mini-Splits(Non-Ducted)
Indoor Model Number(s):MSZ-GL12NA-Ul
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,indeper dent,third party testing:
Cooling Capacity(95F): 12000
EER(95F):13.00
SEER:23.10
High Heat(4717): 14400
Low Heat(1 7F):9200
HSPF:12.50
Sold in?:USA
i
t"Active"Model Status are those that an AHRI Certification Program Particip n is currently producing AND selling or offering for sal ;OR new models that are being
marketed but are not yet being produced."Production Stopped"Model Status are those that an AHRI Certification Program Participar t is no longer producing BUT is still
selling or offering for sale.
Rafin s that are accom nied by WAS indicate an involuntary re-rate. The n published ratino is shown alon with the orevious i. .WAS ratin .
DISCLAIMER
AHRI does not endorse the product(s)listed on this Certificate and makes nq 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 perfc rmance 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
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 wwu.ah rid Irectory.org,click on"Verify Certificate"link
and enter the AHRI Certified Reference Number and the date on which the crrrliflcate was issued, we make life herrer^
which is listed above,and the Certificate No.,which is listed at bottom right.!
02020Air-Conditioning, Heating,and Refrigeration Institute [CERTIFICATE NO.: 132506180671110687