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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 8/23/21 Permit Number: Date: llo ing-P-ermlItAppiication_ —Build .___ Planning and Development Services Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 APPLICATION FOR; PRMIT � Address: 10108 Crosby pl it: 3327-709-0019-000-5 Lot No. Property Tax ID Site Plan Name: Block No, Project Name: domenic Campanella LIKE FOR LIKE A/C CHANGE OUT 4 ton 16a?er, A kw New Electrical Meter Second Electrical Meter... Additional work to be performed underthis permit— check all that apply: XMechanical Tank _._Gas Piping _Shutters _Windows/Doors _Pond _Gas Electric _Plumbing _Sprinklers ,_Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 8426.00 Utilities: _Sewer _ Septic Building Height: J Christopher Langel Name domenic Campanella Name: Sea Coast A/C and Sheet Metal Inc. Address; 10108 Crosby pl company: psi state: fl Address:3108 Industrial 31st Street City: Zip Code: 34986 Fax; City: Ft Pierce state: FL Phone No. 772-485-9674 Zip Code: 14946.Fax: 772-448-4416 F.-Mail: _ Phone No 772-466-2400 Fill in fee simple Title Holder on next page ( if different E-Mail Info(_ seacoastair com from the owner listed above) State or County License CMC035421 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. n xr,_,,��..'"��, .>NY: _Not ApplicableName: =..-Phone:-,.- Address: Cit State:State: FEE_-�` FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name:—_ _Not Applicable 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. St. Lucie County makes norepresentationthat is granting a permit will authorize the permit holder to build the subject structure structure, Pleasle consultor thpyour Home Owlners Association Association drreview your deed for any lestrlts that t ons which maor pppl hlblt such In -consideration of thegrantingof this requested permit, I do hereby agree tha# 1_wil1, in all respects, perform,the wort(__ 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 with lender or an attorney before commencin work or recordin our No ice of Commencement, Signature of Owner/ Lessee/Contractor as STATE OF FL I P COUNTY OF Lao e_ Sworn to (or affirmed) and subscribed before me of Physical Presence or�Online Notarization this 23 day of_g3tJg._ 202( by ('hri5��h�� Lrf�QP.I Name of person making statement, Personally Known X. OR Produced Identification Type of identification Commission No.l"tt"i STATE OF FLOI;ap,A COUNTY OF i (�C"�[ •� S onto (or affirmed) and subscribed before the of Physical Presence or Online Notarization this23day of auk � 2025 by 1 hn%o Name of person inaking statement, Personally Known X OR Produced Identification Type of Identification Notary Public - Eligible for Federal Tax Credit Certificate of Product Ratings AHRI Certified Reference Number : 10259425 Date : 08-23-2021 Model Status :Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: MERIT ML14XC1 SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : ML14XC1-041-230A** Indoor Unit Model Number (Evaporator and/or Air Handler) : CBA27UHE-048-230*+TDR 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, SO, 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. t"Active" Model Status are those that an AHRI Certification Program Padicipanl 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 Certifcation Program Participant is no longer producing BUT Is sllll selling or offering for sale. Retinas 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 products) 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 CertiFlcate. 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; AM 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 far the model cited on this certificate can be verified at www.ahridirectory.org, click 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. ©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132742205081522551