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HomeMy WebLinkAboutCHANGE OUT FORM - CAINAll APPLICAB E INF MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� d�- Permit Number: rV ❑ J U lu� a I t'� E n w. Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fart Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 A, - PERMIT APPLICATION FOR: OL) l PROPOSED IMPROVEMENT LOCATION: Address: So �1ir•,�I�« Property Tax ID #: 13 a 1 '-(0 1 " o 1 & `{ ac ~ I Lot No. Site Plan Name: Block No. Project Name: Q l tl DETAILED DESCRIPTION OF WORK: a- -� - 5 -m 0 ) Ll 5 " r w ;-4 o ,k.tv -e I -�_, e. 4-y- I, - New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: M1 Mechanical _ Gas Tank — Gas Piping _ Shutters — Electric —Plumbing ^ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ _ -r . lzc)o • 60 _ Generator 5q. Ft. of First Floor: Windows/Doors _ Pond Roof Pitch Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Zkm 1 E'6 1_ 5 Address: ��0(1 boLmn �3t • Company:S?Q-z� ti[cnd+t�on-Y)5 '\�'Q,*ly' C e_ City:i�� �G State:4Z Address: t32 l��l Zip Code:3I P3 Fax: City: �t c4 Z-4. r y i __ State)-L Phone No. )39 _ y4 3"Y735 Zip Code: 34941 - - -- Fax:17a-93W - 35 r ! E-Mail: Phone No�" �6`l i5LL7 Fill in fee simple Title Holder on next page [ if different E-Mail i (40 LA "0.CS&.-V lc-G Core] from the Owner listed above) State or County License CflC I L.3 9 v1 If value of construction is 2500 or more. a RECORDED Notice at Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement Is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLIER: _ 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 in which is conf0ct 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 p ted ❑n the jobsite before the first inspection. if t d to obtain financing, consult with 1endWw1qr"vt0rney before commencing work or recording ur No i ` of Commencement. i l � Signature of O. ner see/ ontractor as Agent for Owner Signature of C tra or/ ten Holder STATE OF FLORI A STATE OF LORI f OE4 !S--. L c'ic COUNTY O COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Y Physical Pres nce or Online Notarization � Physical Presence or Online Notarization 'APr'i this Z day of , 2021 by this.L day of Pri l _., 202I by a'm Q.S 1 G 1D S �� CS 01 i✓� p� 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 Produce (Signature of Notary d (Signature of Notary i Natery Put►oo State of Florida „g 'k Notary Public State of Florida �r Je.Commission No. Jennifer �a Commission No. My Coer f ui 1r. 334871 My Carom 339871 Expires 0512912023 Expires 0512912023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20 ram am" CERTIFIED�' certificate of Product Ratings AHRI Certified Reference Number : 204462464 Date: 04-02-2021 Model Status : Active AHRI Type : RCU-A-CB {Split System: Air -Cooled Condensing Unit, Coil with Blower} Outdoor Unit Brand Name : TGM Outdoor Unit Model Number (Condenser or Single Package) : CTVI4CN042A Indoor Unit Model Number (Evaporator andfor Air Handler) : CTA14CO42A Region : Southeast and North (AL, AR, DC, DE, FL, GA. HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, 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($) for which they meet the regional efficiency requirement. The manufacturer of this TGM 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 Equlpment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 42000 SEER: 14.D0 EER (Q) - Single or High Stage (95F) : 11.70 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. Ratings that are accomt�a ied by WAS indicate an involuntary re -rate. The new_12ublished rating is shown slor>a with the previous i.e. WA53 ratiu�. 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 unautharbred alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectoiy.org. TERMS AND CONDITIONS ��, This Certificate and its contents are proprietary products of AHRI. This CertMeate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whale or in part, be reproduced; copied; disseminated; mm. `■ r� 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. AIR4014011TIONING, HEATING, CERTIFICATE VERIFICATION & REFRtGERATION INSTITUTE The information for the model cited on this Certificate can be verified at www. a h r id l recto ry. o rg, Cli Ck an'Ve rify Ce rtif lc ate" Ii nk 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 Witte right. 2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: tasstaaas2a2s45ssn © Michelle Franklin, CFA -- Saint Lucie County Property Appraiser —All rights reserved. Property Identification Site Address: 7506 BANYAN SW Sec/Town/Range: 1413 4 S/3 9 E Parcel ID: 1301-601-0164-000-9 Jurisdiction: Saint Lucie County Ownership Richard M Cain Teresa M Cain 144 Bay Mar DR Fort Myers Beach, FL 33931 Legal Description LAKEWOOD PARK -UNIT 1- BLK 9 LOT 6 (MAP 13`14N) (OR 3796- 1702) Current Values Just/M arket Value: $123.100 Assessed Value: $123,100 lExetnptions: $0 Taxable Value: $123,100 Property taxes are subject to change upon change of ownership. ■ Past taxes are not a reliahle projection of future taxes. ■ The sale of a property will prompt the removal of all exemptions, assessment caps, and special classifications. Taxes for this parcel. SL.0 Tax Collector's Office Download TRIM for this parcel: Download VDF 12 Use Type: 0100 Account #: 461 Map ID: 13114N Zoning: RS-4 Count total Areas Finis hed/Under Air (SF): 1,328 Gross SketchedArea (SF): 2.154 Land Size (acres): 0.22 Land Size (SF): 9,375 Building Design Wind Speed Occupancy Category I II III & 1V Speed 140 150 160 Sourcesilinks! All information is believed to be correct at this time, but is subject to chanjX and is provided without any warranty. (0 Copyright 2021 Saint Lucie County Property Appraiser. All riots resmod.