HomeMy WebLinkAboutTUTTO FRESCO AC PERMIT - AC 7All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J, Permit Number:
7
MOKIUM5fin.
° " ...Y Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:1 J .1 T
-'
Ffr i C
1.
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Site Plan Name: Block No.
Project Name:�,� �_______ __ _
14 q I_iiy + eG�-1�r' T - - - ■
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
wio/echanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1 , r �•
_ Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name 1
Name: Ph I II iS 01
Address: 290 J &a2 0Ix-Hf5--hsqML
Company:il i 1 Q rk-1
i✓
City:. Q(A �� "h1 tate:
Address: LA 5
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Zip Cocle:3`7 CJ 3 V Fax:
ra
City: r tac.� 1 ry U_
State: Pl -
Phone No.
Zip Code: 264ci� 2— Fax:
E-Mail:
Phone No nz. 4l LP.
1 15
Fill in fee simple Title Holder on next page ( if different
E-Mail Yl� S;fi V 11 S
a el .
from the Owner listed above)
State or County License ID—cA
kI cill
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: s Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 areexemptfrom 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 lendaf or an attornev before commencine work or retarding vour Notice of cnmmPnrPnnPnt
I
Signature of Owner/ Less a Contractor as Agent for Owner
STATE OF FLORIDA 0Y
COUNTY OF 1Ni
/
Sworn to (or affirmed) and subscribed before me of � Physical Presence or Online Notarization
this ,±,day of 20Z by
L Jr
Mite o
Name of person making statement.
Personally Known � OR Pr used Identification
Type of Id e tific ion Pr uced
(Signature f N tary(Public- State of Florida
Commission Fl� �7 KRISTIN BAITSHOLTS
No. . p (Seal) ; �`pP�i
;20 - State of Florida -Notary Public
•= Commission # GG 278527
My Commission Expires
a February 19, 2023
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Certificate of Product Ratinas
AHRI Certified Reference Number: 10259546 Date: 07-26-2021 Model Status: Active
AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower)
Series: T-CLASS
Outdoor Unit Brand Name: LENNOX
Outdoor Unit Model Number (Condenser or Single Package) : TSA060H4N4*Y
Indoor Unit Model Number (Evaporator and/or Air Handier): CBA27UHE-060-230*+TDR
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 : 57000
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.50
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.
Ratinas that area
by WAS indicate an involuntary re -rat .The new publish rating Ic snows alanff with the arevious li.e. WAS) reting.
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 Certllicate. 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; Ann `` r' 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 A REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at www.shridirectory. o rg, dick on 'Verify Certificate" 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.
02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132718040979837135