HomeMy WebLinkAboutBuilding Permit Application SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY, Not Applicable
Name : Name :
Address : Address :
City: State : City : State :
Zip: Phone di p : Phone :
FEE SIMPLE TITLE HOLDER; Not Applicable BANDING COMPANY, Not Applicable
Name : Name:
Address : Address:
City: pity:
Zip . Phone : Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT9. 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 isin conflict with any applicable Home owners Association rules, bylaws or and covenants that may restrict or prohibit such
stricture. 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, 1 do hereby agree that ! 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 dull concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNERe: 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 hosted on the jobsite before the first inspection . If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording Notice of Commencement.
�
Signature of Own er/;;tessee/Contractor as Agent for Owner Signature of Contr" aeto' �Puc'-ebse Holder
STATE OF FLORIDA r STATE OF FLORIDA r LA � � '
COUNTY of Ct COUNTY OF
SwKPh
n to (or affirmed ) and subscribed before me of S orn to (or affirmed) and subscribed before me of
ysical Prese- _ _ k�]ce or Online Notarization Physical PresenAce or Online Notarization
this �Q day of [ /1 2020 bV this �Q day of 2020 by
lame of per making statement. Name of person m ing statement.
Personally Known X OR Produced identification Personally Known �_ OR Produced Identification
Type of Identification Type of Identification
Produced Produced,,"~,. Mir=
(signature of Notary Public- -Stafie of Florida (Signature of Notary Public- State of Florida �
Commission No. `[ (S Commission No. (Seal)�
REVI EWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE 00%#4%0 -391L,ARL
COMPLE Eubtic s to at Florida
Rev. o ary u i � Brianna v Lorenz
+P 1% 8sianna V Lorenz �� My Commission HH 042089
My Commission HI-1 042069 expires 09/14l2024
*+ba,, Expires oa/14/7024 o� �.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : 5/10121 Permit Number:
(D
� CID Building Pen- Flit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone : ( 772) 462- 1553 Faxe. ( 772) 462- 1578
P E RMIT APPLICATION FOR : HVAC Mechanical A/C Change Out LIKE FOR LIKE
PROPOSED IMPROVEMENT LOCATION :
Address : 91 %33 Pumpkin Ridge Road Port Saint Lucie , FL 34986
Property Tax ID #: 3322-505-0073-000-0 Lot N 06 64
Site Plan Name : MAIDSTONE ( PB 43- 11 ) LOT 64 (OR 3965- 1795) Block No.
Project Name : HVAC Mechanical A/C Change Out INSTALL RHEEM 5 TON 16 SEER STRAIGHT COOL 10 KW HEATER LIKE FOR LIKE
DETAILED DESCRIPTION OF WORK :
HVAC Mechanical A/C Change Out INSTALL RHEEM 5 TON 16 SEER STRAIGHT COOL 10 KW HEATER LIKE FOR LIKE
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 _ s h u tte rs Wi ndows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction : Sq . Ft. of Fi rst Floor,:
dp
Cost of Construct*0n : $ 5, 700. 00 Util ities : _ Sewer _ Septic Building Height:
OWNER/LESSEE : CONTRACTOR :
............
Name Steven L Miranda Name : Kelly Certosimo
Address : 9133 Pumpkin Ridge Road Company,* Air Temp Air Conditioning
City: Port Saint Lucie State : �, Address : 1384 NW Commerce Centre Drive
Zip Code : 34986 Fax; City: Port Saint Lucie State : FL
Phone NO . (508) 951 -3685 Zip Code : 34986 Fax :
E- Mai 1 : stevestress@comcast.net Phone No (772) 340-0740
Fill in fee simple Tit-le Holder on next page if different E- Mail airtempac@yahoo. com
from the Owner listed above) State or County License CAC1814837
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 require
d .
Eligible for Federal Tax Credit
roduct FZatin 9 s
Aid I
Certified Reference Number : 2012 5245 Date : - -2 21 Model Status : Active
old AHRI Reference Number : 7943714
AHRI Type : RCU-*A-CB (split System,: Air-Cooled Condensing Emit, Coil with lower
Outdoor Unit Brand Name : RHEEM
Outdoor Unit Model Number (Condenser or Single Package) ; RA1660AA
Indoor Unit Model Number (Evaporator and/or Air Handler) : RHlT6024STAN
Region All R CA, Co CT, DC , DE, FL, GA, Ill , III, ILII 7I , KS, K , L , M , MI , ME, M1 , MNINl � NIS,
MT, NC, ND , NE, NH., NJ , NM , NV, 11 SC , SD, TN, TX, UT, VA, VT, War, VVV1 W19 Wy, U .S.
Territories)
Region
Note Central air conditioners manufactured prior to January 1 , 2015 are eligible to be installed En 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 RHEEM product is responsible forthe rating of this system combination.
Rated as follows in accordance with the latest edition of
AHRI2101240 with Addendum 1 Performance Rabng of Unitary Air-conditioning
Air-Source Heat Pump Equipment and subject to ratincuracyg � A I- nsored, independent, third paw testing;
Cooling Capacity 2 - Single or High Stage , ' btu : 57000
SEER : 16.00
EER 2 - Single or High Stage 9 F) 13 .00
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
sell� g or offering for gale i � 1�'I� s r �t�r� ■
el i tl�ret are e n +need � � indicate an in of nta� re-rate. The new bi«hed ratan is shown lorl Wi th re ious (i.e..
.,WAS)
e theproduct(s) listed on this Certificate and makes n representations, warranties or guarantees a to, and assumes n resp nsibility for,
DISCLAIMER
l� l not ado . � . . . ,
the product(s) listed
on this Certificate. AHEM expressly disclaims all liability for damages of an kind arising out of the use or performance of the produ t , or the
unauthorized alteration of data listed on this certificate. Certified ratings are valid only for models and configurations listed in the
directory at www.ahridirectory.org,
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRL This certificate shall only he used for individual, personal and _ .
onf�dent� l reference purposes.a The contents of this Certificate may not in whole le or in part, be reproduced, copied, disseminated; r . . .
AIR-CONDITIONING7 HEATING,
entered into a computer database; or otherwise utilized, in any form or manner or by any mans, except for the user's individual
personal and confidential reference. REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at .ahridire t r ,.or , click on "Verify Certificate" link we makelife betteem
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 bottom right.
Refrigeration Institute CERTIFICATE NOw :
@202 Air-Conditioning, Heating,