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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3/26/2021 Permit Number: ,> Building: Permit Application Planning and Development Services Building and code Regulation Division Commercial Residential X 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 2750 S Brocksmith Rd Ft Pierce, FL. 34945 Property Tax ID#: 2320-501-0057-000-1 Site Plan Name: Subdivision of MC Nurlen Farms Lot Na. 5 Project Name: Liz Gardner Block No. 4 DETAILED DESCRIPTION OF WORK: } AC change out like for like Champion/TC483021 Champion/AE30BX21+TXV 2.5 ton, 15.25 SEER, 8KW New Electrical Meter Second Electrical Meter [:CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: 7�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: Cost of Construction: $ 4700.00 Utilities: `Sewer _Septic Building Height: OWNERAESSEE: ! CONTRACTOR: Name Lisbeth A Gardner Name: Samuel T Durham Address:2750 S Brocksmith Rd Company:Advantage AC of the TC City: Ft Pierce State: FL Address:601 S Market Ave Zip Code: 34945 Fax: City: Ft Pierce State. FL Phone No.772-672-2010 Zip Code: 34982 Fax: 772-465-4945 E-Mail: Phone No772-465-1606 Fill in fee simple Title Holder an next page[if different E-MailAdvantagepermits@hotmaii.com from the Owner listed above) State or County License CAC039664 If value of construction is 2500 or more,a RECORDED Notice o .Commencement is required. If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAND INFORMATION: ❑ESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: 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. 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 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 attorney before commencen work or recording our Notice of Commencement. N C N V Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder 4 0 U d C? N STATE OF FLORIDA STATE OF FLORIDA 'U COUNTY OF St Lucie COUNTY OF St Lucie w U W wa 5 m Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of W z x Physical Presence or Online Notarization x Physical Presence or Online Notarization Z" E this 26 day of_ March 20z1 by this �6 day of_Maw 2011 by Samuel T Durham Samue$T Durham '6 o Name of person making statement. Name of person making statement. Personally Known x OR Produ Known OR Produced Identification JErJitI1FER .C Type of Identific E-0 e of I ntific on Notary Public,State of Produced Commission No.G 'g ice Commission Expires 9/30/2022 (Signature of Not a Public-State of Florida} (Signature of N tar ublic-State of Florida) Commission No. GG263239 (Seal) Commission No. GG263239 (Seal) REVIEWS FRONT ZONING SUPERVISOR; PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. CERTIFIED Certificate of Pr duct Ratingi AHRI Certified Reference Number:8456845 Date:03-26-2021 Model Statu':Production Stopped AHRI Type:RCU-A-CB(Split System:Air-Cooled Condensing Unit,Coil with Blower) Series:LX SERIES Outdoor Unit Brand Name:CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package):TC483021 Indoor Unit Model Number(Evaporator and/or Air Handler):AE30SX21+TXV Region: Southeast and North(AL,AR,DC,DE,FL,GA, HI,KY,LA,MD,MS,NC,OK,SC,TN,TX'i VA,AK,CO,CT, ID,1L, IA, IN, KS,MA,ME,Mf,MN,MO,MT, ND;,NE,NH, NJ, NY,OH,OR,PA,Rl,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 CHAMPION HEATING AND COOLING product is responsible for the rating of this system combination. 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,independent,third party,testing: Cooling Capacity(A2)-Single or High Stage(95F),btuh:30000 SEER: 15.00 EER(A2)-Single or High Stage(95F) : 12.50 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"Modef Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratio s that are accompanied bv WAS indicate an involuntar re-rate. The new ublished ralina is shown along with the previous i.e.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 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 fisted 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 A 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. WMIMM AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make lire better which is listed above,and the Certificate No.,which is listed at bottom right. ©2021 Air-ConditiOning, Heating,and Refrigeration institute CERTIFICATE NO.: 132612554010599458