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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICA13LEI F/OO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A / 1 Permit Number:
° 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: N k u„ ay, M`
PROPOSED IMPROVEMENT LOCATION:
Address: RM ML I atA \1 A � � W I� wh
Property Tax ID#:liwh-;0iU- 0001' n00- tX Lot No.
Site Plan Name: c(oo Block No.
Project Name:m ya S rm►`'�e
DETAILED DESCRIPTION OF WORK:
VA1O
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction. $'4-11 01 o®
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
V
Name: Y
Address: 1
®
Company: Wt(,
fi m
City:
Zip Code:
Phone
State:
Fax:
AddressAll, �Vn� iSu
City:1- n
• ` a(1,
Zip Code: Ili l
Phone No ° 4M GIN
Yr�
State:
Fax:11% . �``�'t�_�n,a
�No.
E-Mail _'f � d�Q \U� ��, AY
Fill in fee simple Title older on next page ( if different
the Owner listed above)
If valnP of rnnctr v+inn it 9CAA .,
E-Mail�olVh
�yense
\Orrfrom
State or CouJ��,���`1
-- -_ _---
_. ..._. °., „ °,�,.�,,,�"� ,wu�. v� �.v1nl7� IlLerneni is requlrea.
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
5t. 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 post n t obsite before the first inspection. If you intend to obtain financing, consult
with lender or an att or commencingwork or recordingour Notice of Commencement.
FSignaturef Owner/ Lessee/contractor as Agent for Owner
FLORIDA �a
COUNTY OF CA •
Sworn to (or affirmed) ark subscribed before me of Physical Presence or Online Notarization
this day of 20 by
Name of person making statement_
Personally wn V/OR Produced Identification
Type of en 'f' ti roduced
(Signature o y Public- State of Florida )
=O� Y P°eli� MARLENE Liu COLL00
Commission No. � (Seal)
* * Commission # GG 171582
Expires
mAr22
�or FL�¢o� Bonded Ttyu g April NotaryO
ervixs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
ev 5 20 21
Unico Air Conditioning Company
1711 Sunset Isle Rd
Ft Pierce, FI 34949
Phone: (772) 678-6676 Fax: (772)647-7525
Contract
Billing Address Document Number 51007510350
Unico Air Conditioning Company 8/9/2021
1711 Sunset Isle Rd
Ft Pierce,Fl 34949
Shipping Address:
Terms of payment:
Term of delivery:
for pick up at HD Supply
Caroline Johnson
Pine Lakes Preserve
7223 Pine Lakes Blvd
Apt 7223
Port Saint Lucie
772-245-4530
Net 15 Days
ZOR(FOB Origin)
Item
Material/Description
Quantity
Unit Price
Amount
1
Install Indoor/Outdoor AC Unit
1
$2,200.00
$2,200.00
Int. Article No. 25937855
2 ton Tempstar 14 seer R410
Subtotal:
Tax:
Shipping
Signature: Grand Total:
$2,200.00
$0.
$2,200
�u::�i DERTiFIED`-
www.ahridireCiory.orgCertificate of Product Ratin
AHRI Certified Reference Number: 201852667 Date .11-13-2018 Model Status : Active
AHRI Type : RCU-A-CB
Series: 14 SEER N SERIES R410A AC
Outdoor Unit Brand Name: TEMPSTAR
Outdoor Unit Model Number (Condenser or Single Package) . NXA424(A,G)KC"
Indoor Unit Model Number (Evaporator and/or Air Handler) : FMA4P24**AL*
Region: North (AK, CO, CT, ID, IL, lA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 TEMPSTAR product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2. 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 (9517), btuh : 22800mi r,1 1 1 2 1F 1
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.
92LQaaghat are accompanied by WAS indicate an involuntanr re-rale Then published rating is shown alone with the previous fie NJAS) 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 www.ahridirectory.org,
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for (ndlvidual, personal ana wimp,
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 users individual,
personal and confidential reference.
CERTIFICATE VERIFICATION REFRIGERATION INSTRUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on `Verify Certificate" link
and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life better"'
which Is listed above, and the Certificate No., which is listed at bottom right.
©2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE N0.: 1318662ODd63162522