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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: %01)1 Permit Number: Z, Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue Fort Pierce FL 34992 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 'Ill Residential PERMIT APPLICATION FOR: PROPOSED IMPRQVEMENT LOCATION: Address: ►1 S V 1 Property Tax ID #: IiIIN - sol - 00 0 0 - U Site Plan Name: Project Name: boiyj& V %SRu0(Q_ DETAILED DESCRIPTION OF WORK: ov"AofAX+105ATi IMA =aya iilllle 1 I i kI vv . ivwM i dof - I MI®l1 I V I lb T' , New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION; (Affidavit required) Lot No._ Block No. Additional work to be performed under this permit -check all that apply: __Mechanical —Gas Tank ,Gas Piping `Shutters Windows/Doors _Pored _ Electric __,_ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of construction: $ % 01). Utilities_ —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name U t Name: Address: Company: 1k City: State: K Address:1110 �1j�j � I�u YA Zip Code: LA Fax: city �N , 1 �� _ Stater Phone No IR f Zip Code: ��L��y `� Fax:1U • qal E-Mail: Phone No • qb •`��D�! Fill in fee simple Title older on next page (if different E-Mail t N�k (,o(' . from the Owner listed above) stet— or �o� �Y LK_.V&YA Qk I I D If Value of construction is 2Soo or more, a RECORDED Notice of Commencement is required If value of HAVC is $7,5013 or more, a RECORDED Notice of Commencement is required. S1 SUPPLEMENTAL. CflNSTRUCTIQN LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: Not A ficable pp MORTGAGE COMPANY: Not Applicable ' Address: Name: Address: City: State: City: Zip- Phone Zip: Phone: State: FEE SIMPLE TITLE HOLDER; Not Applicable Name: Haaress: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip_ Phone: Not Applicable 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 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 WARNINGTO OWNER: Your failu Record a Notice of Commencement may result in paying twice for improvements to r e , Notice of Commencement must be recorded in the public records of St. Lucie Count nd p s on the } site before the first inspection. if you intend to obtain financing, consult with lend or a ne befor Commencin work or recording our Notice of Commencement. Signature of as Agent for Owner STATE OF FLORIDA COUNTY OFA - Sworn o (or afFir anal bscribed be€oke me of this day of V �d b Physical Presence or Online Notarization A_e a A. _ y Name of person making statement. y OR Produced Identification ion Produced (5e'af Notary Public- State of Florida Commission No.4t\lymph_ (Seal) REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED ro�n� aUe�,o MARLENE LILT COLLADO Commission # GG 171582 w9 a� Expires April 25, 2022 T�OF FV Banded Thru Budget Notary servoa3 SUPERVISOR PLANS VEGETATION 5EA TURTLE MANGROVE REVIEW REVIEW REVIEW I REVIEW I REVIEW 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 8/30/2021 1711 Sunset Isle Rd Ft Pierce,FI 34949 Shipping Address: Terms of payment: Term of delivery: Equipment ready for up at HD Supply Caroline Johnson Pine Lakes Preserve 7455 Pine Lakes Blvd Apt 7455 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: $2,200.00 Tax: WVq ��won Shipping $ $0.0 Signature:Grand Total: 2,20 .0 Certificate of Product Ratings 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, 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 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), t: 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 sellin or ofterin for sale. Ratir,;�hat are accom anied by WAS indicate an involuntary re-rateI he new, oublishPd reline Is shown_ ;along with the previous fi.e., WASi 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 pmduct(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 vnvw.ahridirectory.org. TERMS AND CONDITIONSt !!!R� 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 whele or in part, be reproduced; copied; disseminated; �� entered into a computer database, or otherwise utilized, In any forin or manner or by any means, except for the user's indiyidual, personal and confidential rororonc,.. AIR-CdNafTlb NiNtl. HEAT/NO. c F n T, c. c.arr yr sue. F. c nr. o,., Bs RGf=ft49EriATler! IIY3TfruTE The information for the model cited on this certificate can be verified at wwvv.ahrldirectory.orn, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, the make life better" which is listed above, and the Certificate No., which is listed at bottom right. ©2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: '31866200863162522�