HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�a �t Permit Number:
Date:
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°-. Application-_
- -.,.-.".,....—Building-P-ermit
Planning and Development Services X
Commercial Residential
otildingand Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
j
dB D INI R0)ZE ENTm, 0 7[ON, t
TPRO
scarborough ct
Address:9409
3322-507-0029-000-3 Lot No.
Property ID #:
Tax
Block No.
Site Plan Name: _
Project Name: krystyna blank —
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`DE`fhAI�L_�D�DE�GR�,�_�'ION OF�U�IOR`)C� �✓��� �$����`�"�F s,� _ -�� �-
LIKE FOR LIKE A/C CHANGE OUT 5 ton, 16 seer, 10 kw
New Electrical Meter Second Electrical Meter..
z�MR
Additional workto be performed underthlspermit— checkallthatapply:
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:
$ 7548.00 Utilities: Septic Building Height:
Cost of Construction: _Sewer
to
_?,� caRjU`r'R�C„T�orR
�
Christopher Langel
Namekrystyna blank Name.
Sea Coast A/C and Sheet Metal Inc.
Address: 9409 scarborough ct company:
psl State: fl Address; 3108 Industrial 31st Street
city:
FL
Zip Code:34986 Fax: City: Ft Pierce State:
847-525-4155 Zip Code: 34946.Fax: 772-448-4416
Phone No.
Phone No 772-466-2400
E-Mail:
Fill in fee simple Title Holder on next page ( if different E-Mail info Gl7seacoastair com
from the Owner listed above) State or County License CMC035421
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.
L_AU1l INFOR[yIATIID�f�r;h r K �
�(JPP1.EMlT�fiQL�ONSTRI�CT1(;)ijyl���T1 � �
_._ _
DESIGNER/ENGINEER. _ NotFApplicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State: _
--2ip:—---Phone---_—
Zi, _._P-hone-: -
__--- - -
-
-
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 work and installation as indicated,
1 certify that no work or installation has commenced prior to the Issuance of a permit,
St. Lucie CounttflfyyI makes norepresentationthat is granting a permitwill authorize the permit holder to build the subject structure
such
wltli yolur Holne O �ers A soCatlon and your deed for any restrictions whichtmay aprohibit
structurenPleasecconsult review
--In-consideration of thegrantingof this requested. permit, Ldo hereby agree that.l_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 attorneybefore commencin work or recordingour No ice of Commencement.
Z 6/
Signature of Contractor/License Holder
Signature of Owner/ Lessee Contractor as Agent for Owner
STATE OF FLOEtI ip STATE OF FLOfjT I ���
COUNTY OF^LQCt •Q COUNTY OF r` �L1
S rn to (or affinned) and subscribed before me of S o n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or_Online Notarization
by
this ofmarch 202� by this, 2021'
l-_Qday f�fddayof_naarrh
�--� `n `Jt �P h Lr
O r ('J kvh e I- Cif
Name of person m king statement. .1 Name of person maki�n/g statement,
Personally Known X.OR Produced identification—. Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
ignature of Notary Public- tate offFlorida) 4,1,,ure of Notary Publi of Florid
Commission No.�tvoL (Seal ommisslon No,
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This combination
qualifies
for a Federal
Energy Efficiency Tax Credit when
placed in service
between
1/1/2015 and
12/31/2020,
AHRI Certified Reference Number : 201299487 Dale : 03-09-2021 Model Status :Active
Old AHRI Reference Number: 7984223
AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower)
Series: GSX16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX160601 F*
Indoor Unit Model Number (Evaporator and/or Air Handier): ASPT61 D14A*
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until June 30, 2016. Beginning July 1, 2016 central air conditioners can only be installed in region(s) for
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2021Atr-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: l32e97915665598700