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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7/13/2021 Permit Number: l ;l lu�� L L 0 L I L Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential XXX 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 116 Queen Ann Court Property Tax ID#: 1414-702-0032-000-2 Lot No. Site Plan Name: Block No. Project Name: McFarlane-Residence DETAILED DESCRIPTION OF WORK: Like for Like HVAC Lennox System Replacement-18 Seer-10kw-3 Ton-Vertical-Ground New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: )CMechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 7398.00 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Mor-hatl MrrFarlana Name: Don Miranda Address: 116 Queens Ann Court Company: Miranda Plumbing &Air Conditioning City: Fort Pierce State:R Address: 750 NW Enterprise Drive Zip Code: 34949 Fax: City: Port St Lucie State: FL Phone No. 772-878-5123 Zip Code: 34986 Fax: E-Mail: Phone No 772-878-5123 Fill in fee simple Title Holder on next page ( if different E-Mail Idiodato(a)mirandacompanies.com from the Owner listed above) State or County License CAC1815486 Lva of construction is 2500 or more,a RECORDED Notice of Commencement is required. of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTI70MZENC7T. M e signed by owner gent and applicant: (Signature of contractor) (Signature of Owner or Agent(including contractor)) State of Florida,County of —51L L t4 e, t State of Florida,County of _SLt- Li-�, c i cr K-1 ed to and subscribed before me this Affirmed to and subscribed before me this 20 2 t ,by 6 20 �1 ,by e p ally known to me or who has produced personally known to me or ho has produced 43xr ag-id tification. as identification. 7^n a Nit Signature: Notary Signature: zX0 p o t (print name) �-� < o CtA�' 6 Notary(print name) L b�• 1 �'�'�°'� T 'CVO p ns ction documents must accompany this application.The Florida energy code submitted bee o _ ''"Y° TO�To o I c- , of FljAssn. d must pass final inspection. `Notice: In addition to the requirements of this permit,there itior j„ FAkictiMS000 applicable to this property that may be found in the public record of this county,and there may be a d iRSt `peI"M4tKFe i N&kar 3, from other governmental entities such as waste management district,state agencies,or federal agen " " f 1 ry, APPLICANT MUST BE NOTARIZED.If owner builder,applicant must sign in person.BUILDING PERMIT includes: Building,Electrical,Plumbing,Mechanical,and Sewer only. All other trades require separate applications. Asbestos compliance: It is the owner's or operator's responsibility to comply with section 469.003,Florida Statutes,and to notify the Department of Environmental Protection of his or her intentions to remove asbestos,when applicable,in accordance with state and federal law. FEE SIMPLE TITLEHOLDER,BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN THE AGGREGATE VALUE(TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORIZED BY THE INDIVIDUAL PERMIT)IS$2500 OR MORE(EXCEPT HVAC REPAIR/REPLACEMENT<$7500). PLEASE ADDRESS ALL ITEMS. Fee Simple Titleholder's ❑Same as Owner Bonding Company ❑Not Applicable Name(if other than owner): Name: Address: Address: City: State: Zip: City: State: Zip: Mortgage Lender's ❑Not Applicable Name: Address: City: State Zip: OFFICE USE ONLY Is the property located in a Special Flood Hazard Area(floodplain)per the current Flood Insurance Rate Map(FIRM) ❑Yes ❑No Flood Zone: Reviewed by: Determination: Permit Fee $ Other $ Plan Review Fee $ State Surcharge $ Other $ Routing Fee $ Subcontractor $ Flood Review Fee $ Other $ Total Amount Due at Issuance $ Active Code Violation❑Yes❑No Remarks Case# Case Type Reviewed by Date Final Check Date Page 2 of 2 S AHRI Certified Reference Number:206215607 Date;07-13-2021 Model Status:Active AHRI Type:RCU-A-CB(Split System:Air-Cooled Condensing Unit,Coil with Blower) Series:ELITE EL18XCV SERIES Outdoor Unit Brand Name:LENNOX Outdoor Unit Model Number (Condenser or Single Package):EL18XCV-036-230A** Indoor Unit Model Number(Evaporator and/or Air Handler):CBA25UHV-036-230-** 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 Note: 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. The manufacturer of this LENNOX 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:35800 SEER: 18.00 EER(A2)-Single or High Stage(95F) : 12.20 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 selling or offering for 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, 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 unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at 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;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at click on" "link we make life 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. ©2021 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 132706545483813079