HomeMy WebLinkAboutBuilding Permit Package All APPLICABLE IJFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dal Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial V7 Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Site Plan Name: Block No,
Project Name: kv VC�t'.Ojr,,A TJ100J CIL46 tL01+*!5*
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New Electrical Meter Second Electrical Meter
7 Additional work to be performed under this permit-check all that apply:m-echanical —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: $ Utilities: Sewer Septic Building Height:
Name:1,3 I OJ 6 A Name c4 kwr5 e,i&i-ri
��C- ClAb C-0, (a, QX 6 .
Address:JOIJIL7 5 , ()ccal ()r.
Company: 60MCS 1)*
city:_�wfm 6cock State, FL-, Address: 305-1 JV V'� gwj _L
Zip Code: ;J-1 15 7 Fax: City: 1-d1t a rl'f C State: 1-:t-
Phone No. Zip Code: 34/416 — Fax:
E-Mail: Phone No 712_-'1b1 - K71)
Fill in fee simple Title Holder on next page if different E-Mail C4 ( PO()/V rvj''
from the Owner listed above) State or County License
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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.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Dame: _
Address: Address:
City: State: City: State'
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER; ^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 work and installation as indicated.
l 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,wails,signs,screen roams and accessory uses to another non-residential use
"VARNINC TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF C[MM94CEMENT MAY RESULT Big YOUR PAYING
TWICE FDIC IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST DE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
C.
S' ature of Owner/Lessee/Contractor as Agent for Owner SF ature of Contractor/License Holder
STATE OF FLORIDA ti STATE OF FLORIDA .
COUNTY OF Ste. COUNTY OF =1 truer L--
The wing instrument wac acknowledged before me The forgoing instrument was acknowledged before me
this*day of _ 20_,7 i by this 2dayof 'S�t✓I 20 by
r�✓rr?} ��P'r >�P� `��9�CS � �d'i,'/✓I iP,�
Name of person making statement. Name of person making statement.
Personally Known, OR Produced Identification Personally Known !� OR Produced Identification
Type of identification Type of identification
Produced Produced
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Signature of Notary Public-State of Florida) nature of Notary Public-State of Florida)
Commission No. (S&gANMQNTl NEGRD Qmmi5sion No. SU(90WbNTrNEGR0
MY COMMISSION#GG 08509 MY COhIMI:aION#C0 089099
EXPIRES;April 2,2021
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REVIEWS FRONT � t `" NS VEGETAT! u�ICundefwilCl�
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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00ILM CERTIFIED
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Certificate of Product Ratings
AHRI Certified Reference Number:7167312 Date:01-21-2021 Model Status:Active
Old AHRI Reference Number :
Product :Water-to-Air and Brine-to-Air
Model Number : 50VQP120""3A
Brand Name :CARRIER
Ratted as follows in accordance with ANSIIAHRIIASHAREIISO Standard 13256-1 Water-toAir and Brine-To-Air Heat Pumps and subject to
verification of rating accuracy by AHRI-sponsored,independent third party testing:
Full Load Part Loadi Part Load2 Part Load3
Air Flow Rate-Cooling: 4000
Air Flow Rate-Heating: 4000
WLHP(Water-Loop Heat Pumps)
Coaling Capacity(Btuh) 117000/117000
Cooling EER Rating(Btuhlwatt) 13.20113.20
Cooling Fluid Flow Rate(gpm) 28.00
Heating Capacity(Btuh) 1420001142000
Heating Cop(watt/watt) 4.4014.40
Heating Fluid Flow Rate(gpm) 28.00
GWHP(Ground Water-Heat Pumps)
Cooling Capacity(Btuh) 134000/134000
Cooling EER Rating(Btuh/Watt) 18.30118.30
Cooling Fluid Flow Rate(gpm) 28.00
Heating Capacity(Stuh) 123000/123000
Heating COP(watt/watt) 3.90/3.90
Heating Fluid Flow Rate(gpm) 28.00
GLHP(Ground-Loop Heat Pumps)
Cooling Capacity(Btuh) 127000/127000
Cooling EER Rating(Btuh/Waft) 14.70/14,70
Cooling Fluid Flow Rate(gpm) 28.00
Heating Capacity(Btuh) 100000/100000
Heating COP(watt/watt) 3.2013.20
Heating Fluid Flow Rate(gpm) 28.00
Indoor Blower Motor Fan Type :PSC
Sold In? :USA
Where rating shows value/value,the first value is at minimum voltage,the second value is at 230v for a dual volt system.
t"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.
Rati 2s_fhat are accompanied by_WA$indicate a�i�zoluntary re-rate. The new❑ublished rating is shown alone with the rr�revious ri aWAS}rating
1.1.14n-.G minmi.i�l�:l
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 As
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 www.ahrid!rectory.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 listed at bottom right. —
9)2021 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 1 32557093 59626 55 08