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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 05/14/2021 Permit Number: 1�lr O Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR:Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 816 Nettles Blvd Jensen Beach , FL 34957 Property Tax ID #: 4502-501-1002-000-2 Site Plan Name: Project Name: Richard Klein & Kathleen Gentile Klein DETAILED DESCRIPT_IO_N OF WORK: replace a/c equipment like foir like change out Residential X Trane- Mitsubishi / NTXMMX36A142A , (1) NTXWST18A112A (2) NTXWST09A112A 3 TON, 19 SEER HEAT PUMP New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: X Mechanical _ Electric Gas Tank _ Plumbing Total Sq. Ft of Construction: _ Cost of Construction: $ 7500.00 _Gas Piping _Shutters _Sprinklers _Generator Sq. Ft. of First Floor: Lot No. Block No. _ Windows/Ddors _ Pond Roof 1 Pitch Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: NameRicard Klein Name:Timothy Wojcieszak Address:816 Nettles Blvd Company: Krauss & Crane City: Jensen Beach State: _ Zip Code: 34957 Fax: Phone No.440-865-0011 Address:904 SE Dixie Hwy City: Stuart State: FL 772-283-4055 Zip Code: 34994 Fax: Phone N0772-287-1227 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mailadmin@kciac.com State or County LicenseCAC18187 6 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 required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 commencing work or recording your Notice of Commencement. Signature of Ow r/ Lessee/ ontractor Is Agent for Owner Signature of Con ctor/Liter a Holder STATE OF FLORIDA p /, MC��� STATE OF FLORIDA wtoi n COUNTY OF i'� COUNTY OF SworD to (or affirmed) and subscribed before me of Sw� to (or affirmed) and subscribed before me of V Physical Presence or _ Online N tarization Physical Presence or 0 n I i a Notarization this IL day of 202(� by this JLL day of kA(Aq_ 02p by I t o �11DI/nf.S zGK— Ti mo4ij w01GI-la SZiq14-- Name of person mak g ssttate ent. Name of rson making t� teme t. pe Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification Ty f Identification Type of Identification P oduc d Pr uc gnature of Nota Ic- Sta re of Notary P lit- stat Commission No.Ci�aa�s �VI Notary Public State of `'� I)Cemeron Lynn Owes My Commission GG 3 lonoa y� o Notary Public State of FIC mm sion No. l ?eC�neron Lynn Owen fs9 ommimon GG 322 a Expires 04111/2023 �p�t° Expires 04111/2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TIJRTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/ZU Certificate of Product Ratinqs AHRI Certified Reference Number: 202354903 Date: 05-17-2021 Model Status: Active AHRI Type: HMSV-A-CB-O (Multi -Split Heat Pump, Free Delivery) Series Name: M-Series Outdoor Unit Brand Name: Trane / Mitsubishi Electric Outdoor Unit Model Number: NTXMMX36A142A' Indoor Type : Nan -Ducted Indoor Units Rated as follows in accordance with the latest edition of AHRI 210/240 with Addendum 1, Performance Rating of Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independ Cooling Capacity (95F) : 35400 EER (95F) : 9.40 SEER: 19.20 High Heat (47F) : 36000 Low Heat (17F): 22200 HSPF : 11.00 Sold In? : USA party testing: 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 Slopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. RR .a that are a.no anted by WAS Indicate an involunlary re -rate. The new published rating is shown along with fhe previous (i.e. WA51 retina. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees asto, and assumes no responsibllityfor, the product(s) listed on this Certificate. AHRI expressly disclaims all Ilablllty 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 listed 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 confidential reference purposes. The contents of this Certificate may not, In whole or In part, be reproduced: copied; disseminated; entered Into a computer database; orotherwlse utilized, In any form or manner or by any means, except for the user's individual, personal and confidential reference. AIR�CONDRIONING. HEATING. CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahrid Irectury.org, click on'Verify Certificate' link we make life bclier'- 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. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132657255927609760