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HomeMy WebLinkAboutCHANGE OUT FORM - WAGNERAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �O5� Permit Number: (} Q L3 f) D QsaIfrlinn Darmit ❑nnliratinn Planning and Development Services Building and code Regulation Division Commercial Residential 2300 Virginia Avenue, Fart Pierce F! 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: AC Ch"%t 00-1` k PROPOSED IMPROVEMENT LOCATION: -� Address: c5 D 1"CC.V- S )Ft- 1QC' G2� a Property Tax ID #; 3 y 10 — JOB Go r Lot No. Block No. site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: 5 z-e r ACOA1 e. ❑J�- +0 3.5 `O a-t� iv 5 G r New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: Mechanical — Gas Tank — Gas Piping — Shutters Electric ^ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ 61 0 �? OWNER/LESSEE: Name r7 o( Address:_ 52-1 City: ki f Generator 5q. Ft. of First Floor: Windows/Doors Pond Utilities: _Sewer _Septic CONTRACTOR: State: �L Zip Code: I Fax: Phone No. �$ E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Roof Pitch Building Height: Name: zkm 1 I Cam an S �� rtdtifio't'NV) C,IViC.�_ _ P y: Address -.- City: ��, StateTL Zip Coder �� Faxa %lq ` 35 d I Phone No 2-` I-0 E-Mail i�1� u 0.C5P.rVIG-L CC7� 1 State or County License CflC I �.3 1f 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. 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 SIMPLETITLE 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. 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 contlict 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 on the jobsite before the first inspection. If �tdd to obtain financing, consultwith lend��rney before commencin work or recordin f Commencement. Signature as Agent for owner I Signature of STATE OF FLORl �I} COUNTY OF �--�TC)r4 S� . LUU Sworn to (or affirmed) and subscribed before me of Physical Prese�1ce or Online Notarization this � day of `IIAPf-jT 2021 by � cl�m is 1 CA) 01 S Name of person making statement. Personally Known � _ OR Produced Identification — Type of Identification Produced (Signature of Notary it Notary Public State of Florida r Commission No. Jennifemy comrr G 339871 w6ft'wExp rO oerzsr 023 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE Com STATE OF COUNTY zmr:rm L uEvc Sworn to (or affirmed) and subscribed before me of X Physical Preseve orr^ Online Notarization this 5 day of i-*-e ^P 2021 by �TQ- r Name of person malting statement. Personally Known Z' OR Produced Identification Type of Identification Produce (Signature of Notary N Wary Public 5t9te W Florida Jennifer I u' Commission No. my commi 332971 w R Expires 08I2W2423 S REVIEWOR I REV EW NS IVEGETATI EV EWON ISE REVIEWLE MANGROVE REVIEW This combination qualifies for a federal Energy Efficiency Tax Credit when placed in service between 1/1/2015 and 12/31/2020. Certificate of Product Ratings AHRI Certified Reference Number. 201664307 Date : 04-05-2021 Model Status : Active Old AHRI Reference Number : 8242634 AHRI Type . HRCU-A-CB (Split System: Heat Pump with Remote Outdoor Unit -Air -Source) Series: GSZ14 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSZ140421 K' Indoor Unit Model Number (Evaporator and/or Air Handler) : ASPT49014A' The manufacturer of this GOODMAN product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 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 : 40000 SEER : 15.00 EER (A2) - Single or High Stage (95F) : 12.50 Heating Capacity (H12) - Single or High Stage (47F) : 39000 HSPF (Region IV) : 8.50 t"Active" Model Status are those that an AHRI Certification Program Participant is currenSly producing AND selling or offering for sale; QR new models that are being marketed but are not yet being prod uced.'Prod uction Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering ftir sale. ,RRatinos that are accompanied by WAS dicste an involuntary re -rate, The new published a ina is shown alono with t e previous 6,e. WAS) ratttc DISCLAIMER AHRI does not endorse the products) listed an this Certificate and makes no representations, warranties or guarantees as to, and assumes no responslbillty for, the products) listed on this Certificate. AHRI expressly disclaims all Iiah11ity for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data Ilsted on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahrid Irectory.arg. 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; �. No r entered into a computer datahase; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. Alit-consomONIN4HEATING, & REFRIGERATION;NSTrrUTE CERTIFICATE VERIFICATION The information €orthe model cited on this certificate can be verified at www.ahridiroctory.org, click on "Verity Certificate" link %,v make lire better" and enter the AHRI Certified Reference Number and the date an which the certificate was issued, which is Ilsted above, and the Certificate No., which is listed at bottom right. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132621095324168037 Michelle Franklin, CFA-- Saint Lucie County PropertyAppraiser— All rights reserved. Property Identification Site Address: 5930 TRAVELERS WAY Secfrown/Range: 1013 6S140E Parcel ID: 3410-503-01 13-000-7 Jurisdiction: Saint Lucie County Ownership Tanya Wagner 13528 59th Ct Royal Palm Beach, FL 33411 Legal Description PALM GROVE S`D 13LK D LOT 17 (0.12 AC) (OR 3182-2Z1, 223) Current Values JustlM arket Value: $132,400 Assessed Value: 5132,382 Exemptions: $0 Taxable Value: $132,382 Property taxes are subject to change upon change of ownership. • Past taxes are not a reliable 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: SLC Tax Collector's Office Download TRIM for this parcel: Download P D F 19 Use Type: 0100 Account #: 133232 M ap ID: 34110S Zoning: Planned 17n Total Areas Finishcd/UnderAir (SF): 1,450 Gross Skctched Area (SF): 1,972 Land Size (acres): 0.12 Land Size (SF): 5,227.2 Building Design Wind Speed Occupancy Category I Ill 1111 & IV Speed 140 160 170 Sources. -links: All information is believed to be correct at this time, but is subject to change and is provided without any warranty. C) Copyright 2021 Saint Lucie County Property Appraiser. All riots reserved.