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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-& CERTIFICATE OF PRODUCT RATINGAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: �`v,Q LUY0111� ° Building Permit Application Planning and Development Services �.� i Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 CBDG Funding Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address:� �-r'L,9� � 1 01 �� 11 14 �,Q) Lot No. Property Tax ID #: Site Plan Name-�rl- PQ a �'� U C Dee n e s Block No. Project Name: DETAILED DESCRIPTION OF WORK: l l 4-- New Electrical Meter Second Electrical Meter (Affidavit required) FONSTRUCTION INFORMATION: Additi0 I work to be performed under this permit- all that apply: Windows/Doors Mechanical _ Gas Tank _ Gas Piping Shutters Pond — — Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 160 Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: I CONTRACTOK: Name e5 Address: ) y .(i�GL City: ,rm <1 a r- State•MiP Zip Code:.P/o'? Fax: Phone No. 5-/ % - �J - / 4 E- Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: rn,�tiael %5�-zurA4 Company:',�:,�.��5 L>'��r.�� Address,^. 3 S 42 -3 City.f'1�n D, &C:4 State Zip Code:' J� % �/ Fax: Phone No E-Mail r,415 State or County License 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 CONST UR CTI DESIGNER/ENGINEER: Name: ` Address: City: Zip: Phone LAW INFORMATION: Applica State: — FEE SIMPLE TITLE HOLDER: L—Not Applicable Name: Address: City: ZIP: Phone - MORTGAGE COMPANY: =' Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: � qp Ip acI b elel 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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure which is in convict with any applicable Home Owners Association rules, bylaws or an �covenants that may restrict or prohibit structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply, such 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 8uilding 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 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 ATTQTO OBTAIN ANCING, CONSULT WIT"POUR !ENDER O�iAIN tiifVEY p;EF®RE REC ORDING YOUR Nn� �r,.., ,O.,..�_ OBTAIN Signature of Owner Les a/Contractor as Agent fo wrier STATE OF FLORIDA COUNTY OF 7/L/ The for L'ging instrument was acknowledged before me this day of OC -o 20 -ja by Name of person mak:70R ment. Personally Known _ produced Identification Type of Identification Co of Notalty Public- State of Florida ) e-i 1 i- i. SWEeT (5e; `votary public - State or Florida Commission : GG 315466 REVIEW COUNTER REVIEW DATE RECEIVED DATE COMPLETED Signature of Contract /License Holder STATE OF FLORIDA COUNTY OF The forgoing instr m n was acknowleZdogegbefore me this � day of �( ��Xa b ii d r —7C--fir=� AL :J y • Po guti maxingst ement. `J Personally Known Type of Identification OR Produced Identification PyOuced Of Notary Xublic- State of Florida Commission SUPERVISOR I PLANS REVIEW REVIEW KLLUE J. SWEET hoary aublic . State of Florida IANGROVE REVIEW Certificate of Product Ratings AHRI Certified Reference Number: 10197403 Date : 08-23-2021 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: 14 SEER R SERIES R410A AC Outdoor Unit Brand Name: ARCOAIRE Outdoor Unit Model Number (Condenser or Single Package) : R4A436(A,G)KB` Indoor Unit Model Number (Evaporator and/or Air Handler) : FEM4P36"AL Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, AK, CO, CT, ID, IL, IA, 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 ARCOAIRE 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 : 33000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 12.00 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 www.ahridirecto►y.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; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link w ,, okv hic boui r 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. 132742007160025675 ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: