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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7/13/21 Permit Number: LL1L.1('(dQL� wilding ver=.Appli 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; Address: 4914 hickory dr Residential X ID #: 3402-608-0202-000-5 Lot No. Site Plan Name: Projame: ect N LIKE FOR LIKE A/C CHANGE OUT 3 ton, 15 seer, 8 kw New Electrical Meter Second Electrical Meter. Additional worl<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: $ 6959.00 ,_Generator Sq. Ft, of First Floor: Block No. Windows/Doors _Pond Roof Pitch lJtilities: _Sewer Septic Building Height: Name jean glenton Address:4914 hickory dr City: fort pierce state: fi Zip Code: 34982 Pax: Phone No. 772-204-5096 E-Mail: Fill in fee simple Title Holder on next page ( if different from the owner listed above) Name: �nnstopner t_angel company: Sea Coast A/C and Sheet Metal Inc. Address:3108 Industrial 31st Street city: Ft Pierce state: FL Zip Code: 34946 Fax: 772-448-4416 Phone No 772-466-2400 E-Mail info �seacoastair com Sta to or County LicenseMC. C035421 value of construction is 2500 or more, a RECORDED Notice of Comm �1F_QRIUIfA�I©�� �x r y � ._ � `` �, � ���� .�MORTGAGE COMPANY: _Not Applicable r777�7= Name; Address:City: State:h-__Zip.----,—Phone--....._.. -- FEE SIMPLE TITLE 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 msrauanon as nwiceieu. I certify that no work or installation has commenced prior to the Issuance of a permit. St. Lucie Courtmakesmakes norepresentationthat is granting a permit will authorize the permit holder to build the subject structure structure, Please consultwithpyourHome OwOwners ers A sociation and review your deed for any restrlthaot mwrestrict ic� tmcaat, approhibit such In -consideration of the -granting -of this requested.pennit, I.do hereby agree that l.will, In all respects, perform,the worl<..._ 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 .. ,. ,.c r�.,..� an, as Agent for Owner STATE OF FLO,�IpFf �� COUNTY OF V.... Sworn to (or affirmed) and subscribed before ma of Physical Presence or Online Notarization this l day of lUly 202( by i r ( t) I r�r�he rta P 1 Name of person m king statement. Personally Known OR Produced Identification Type of Identification % Notary commission dusTli+AL, of STATE OF FLOf;Ip,A COUNTY OF � l a � nto (or affirmed) and subscribed before me of Na S o Physical Presence or _Online Notarization this 13 dayof�ul 2026 by me of person making statement. Personally Known OR Produced Identification Type of Identification of Notary Public- Statelof Florida AHRI Certified Reference Number : 201830198 Date : 07-12-2021 Model Status ;Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: GSX16 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX160371A' Indoor Unit Model Number (Evaporator and/or Air Handler) : ASPT39C14B' Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S. Territories) Region Nole : 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(s) for which they meet the regional efficiency requirement. 1"Active" Model Status are those that an AHRI Certifcation Program Participant is currently producing AND selling or offering for sale; OR new models that are being marketed but are not yet being produced:'Produclion Stopped" Model Status are those that an AHRI Cedihcalion Program Participant is no longer producing BUT Is still selling or offering far sale. Ratings that are accompanied by WAS indicate an involuntary re -rate... The new Published rating is shown along with the previous (i.e. WAS) rating. 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, tIte protluct(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 unauthorized alteration of data listed on this Certificate. Certified ratings are valid ally for models and configurations listed in the directory at www,alirldirectory.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 whale or in part, be reproduced; copied; disseminated; 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. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www,alirldlrectory.org, click on "Verify Certificate" link we make Zile 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 bottom right. 02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132705966920869570