HomeMy WebLinkAboutCHANGE OUT FORM - COFFEEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: n �-1 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2 300 Virginia Avenue, Fort Pierce FL 349E
Phone: (772) 462-15 Fax: (772) 462-1578
j PERMIT APPLICATION FOR: CJn
Residential
.P1
PROPOSED IMPROVEMENT LOCATION: I
Address: 1(05 Li'n
�44 IS- 4V 6C ,
Property Tax ID#
y-3i, s r s— 1--coo Lot No.
Site Plan Dame:
Project Name:
Block No.
4
DETAILED DESCRIPTION OFWORK:
Chafe o��- �
etht,4-r- *i
)-),, A f St-` i
New Electrical Meter Second Electrical dieter,
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
&Mechanical
Electric
Gas Tank
Plumbing
Taal 5q. Ft of Construction:
Cost of Construction:
W E R/LESSEE:
NaMe
Address: -I
City- � r
WIN
Gays Piping
Sprinklers
State:
Shutters
Generator
q. Ft. of Fiat Floor:
Windows Doors ,^ Pond
Roof Pitch
Utillties: iSewer — Septic Building Height:
Zip Code: 3 5'A Fax:
Phone No.??
k E-illlai�
Fill in fee simple Title Molder on next page ( if different
from the Owner listed above)
CITRACTR-
Name: tz - �'
Company: Q-Q-&r 4 1 1 J k c
Address- t�30 -n+ CLQA- III
City: VOC4 State L
Zip Code: Fax.-In-MLi
--
Phone o "7— Y"'I I J 14S LID
E-Mail rJu o 6zeV Imo.. Co or
State or County License CAS I �9 1�&3, 9 - —
if naive of constructian is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HA►VC is $7,,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL I TR U TION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: ,Not Applicable
Name:_
Add ress:
City:
Zip: Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: _. _ State:
Zip: Phone:
BONDING MP A Y: Not Applicable
Name:
Address:
City:
Zip: Phone:
NER 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.
t. LucieCounty makes no representation that is granting a permit will authorize the pemit holder to build the subject structure
which is in conflict with any applicable Horne Owners Association rules, bylaws or an covenant that may restrict or prohibit such
structure. Please consult with your Home Owners AkssDciation 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 t. 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
WAR NIN TO OWN ER: Your failure to Record a Notice of Commencement may re SU[t 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 ,tad on the jobsite before the first inspection, ff t d to obtain financing, consult
with lead t rr a before commencin rorl or recordingur No i of Commencement.
Signature of Q ner see/ antractor as Agent far Owner
STATE OF EL RI ACOUNTY OF- 0r4 LuUk'
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
tFs_"'�L day of , 021 by
ko I-S
Name of person making statement.
Personally Known �_ OR Produced Identification
Type of Identification
Produced
Signature of Cfitraor cen Molder
STATE OF L R I � - s
COUNTY F -'k � f ., .�LK_
Sworn to (or affirmed) and subscribed before me of
Physical Presen a or Online Notarization
this day of 2021 by
�TC_4_m CS &) 101.
Name of person making statement.
Personally Known ��. OR Produced Identification
Type of Identification
Produced
(Signature of Notary RU {.5ignature of Notary
Notary Pvbk State of Flofida � � Notary Fubi� State of Florida
Commission siar� o. Jenniter r Jennifer �
iwAy omMrG 339871 COfYlr1i1551 n No. My ommi 339�T1
Expires 0512512023 � � Expires 05 $12023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
e,
Eligible for Federal Tax Credit
Certificate of Product Ratainas
AHRI Certified Reference Number : 201785 74
Date'. 05-07-2021
AHRI Type. RCU-A-CB (Split System: Air -Cooled ondensing Unit, Coll with Blower)
Series : GSX16
Outdoor Unit Brand Name . GOOOMAN
Outdoor Unit Model Number (Condenser or Single Package) ' GSX16S421Aft
Indoor Unit Model Number (Evaporator andlor Air Handler) - APT49D14A*
Model Status: Active
Region: Southeast and North (AL. AR, DC, DE, FL, GA, H1, KY. LA, MD, M S. N G. OK. SC, TN, TX, VA, AFC, CO, CT. ID, IL,
IA, IN, I{ S, MA. ME, M1. M N, M0, MT, ND, NE, NH, NJ, NY, OR OFF, PA, FBI, 8 D. UT, VT, WA. WV. Wl, 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. 016_ Beginning ,July 1, 2016 central air conditioners can only be installed in region(s) for
which they rneet the regional efficiency requirement.
The rn a n ufactu rer of this GO0DMAN product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHR12101240 with Addendum 1 r 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) - S inglie or High Stage (95F), btu : 41000
SEER ; 16,00
EER (A2) - Single or High Stage (9SF) : 13,00
t"Active" Mwel Status are those that an AHRI GerliTication Progr'em Paricipant is currently producing AND selling or offering for sale: OR new models that are being
marketed but are not yet being prod uced.`Prvduction Stopped- Model Status are those that an AHRI Derlirication Program Participant i5 no kD�nger producing BUT is still
selling or offering for sale_
Ratinos that are acoamoanPed bar WAS indicate an involuntary re- rate- The new published rating is shown Mona WO the Drevious i'k_e_ WAS rating.
DISCLAIMER
AHRI does inot endorse the products) listed vn this Certificate and makes -no representations. warranties or guarantees as to. and assumes no respo nsi Wl ity 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
onauthorized alteration of data Ilsted on this CertIfIcate- Certified ratings are valid only for models and con}fgufation% Ilsted In the
directory at www.ahridireotoxy.org.
TERMS AND CONDITiONS
At 1JF
This Certificate and its contents are prior etary products of AHRI. This Cortifrcato shall only be used for Individual, personal and
co-nfidential reference purposes. The contents of this Certificate may -not. in whole or In part. be reproduced: copied; disseminated; psoOn
ILI
entered into a computer database, or otherwise utilized, in any form or manner or by any means, except for the user's InaMdual.
Personal anti confidential reference. 1wIR 0#�IDITICI IN{�, HEATING.
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.athrFd Irectory.org. click on 'Verify Certificate" link
anO eater the AHRI Certified Reference Number and the date on which the certificate was issued,
which is listed above, and the Certificate No., which is Ilsted at bottom right. F
0 1 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE TE NO.:
& REFRIGERATION INSTITUTE
we nia6life tK#ter-
1326075 89503ZM
Michelle Franklin, FA-- Saint Lucie County PropertyApprai r --All rights reserved.
Site Address. 765 LINDO LN
SecTown/Ran gv: 2 2 /3 6 SA 0 E
Parcel IDS 41 -� 15-0167-000-4
Jurisdiction: Saint Lucie County
Ownership
Alec Coffee
765 Lindo LN
Port St Lucie, FL 34952
Legal Description
RIVER PARK -UNIT 3- BLK 26 LOT 10(MAP 34'22S)
Current Value's
Just '.Markct Value: $125,700
Assessed Value; $53,290
Exemptions: $28.290
Taxable Value: $25.000
Property Identification
Usc Type: 0100
Account 4, 42235
Map III: 4/22S
Zoning RS-4 Count
tom:...►' - ., . - , � • - � `� _ � �' _ _ .
Property taxes are subject to change upon Total Areas
c h a n a of ownership. Finished/Under Air (SF) 1,199
■ Past taxes are not a reliable projection of future Gross Sketched Area (SF): 1,981
[axe S. Land Stye (wren): 0.19
• The sale of a property will prompt the removal of
all exemptions, assessment C�IpS, and spkcial Land Size (SF"): S,?56
elassiflcatiotts.
Building Design Wind
Ta= for this parcel•. SLC Tax Collector's 0Mee 19
DoVrnload TRIM for this parcel. Download PDF 12
Speed
occupancy C."ategoty 1 II III& IV
Speed 140 160 170
Sourcer, 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 Coutily Property Appraiser.All rights reserved.