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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPL WE INFO MUST 13E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � D i I
Permit Number:
L IT0
V PROM. Building Permit Application
Planning and Development Services
BUildina and CadO RegvlaHan Division Commercial
2300 Virginia Avenue, Fort' Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: l S m1 wt
Property Tax ID #: — SITS — 00 0 '� _ 0 Q
Site Plan Name:
Project Name: k 1V, VnIf ok v yll C,eutlo
DETAILED DESCRIPTION OF WORK:
V km-t1.,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
1►I
(Affidavit required)
Additional work to be performed under this permit — check all that apply;
Mechanical Gas Tank Gas Piping -- p g Shutters Windows/Doors
— Electric _ Plumbing — Sprinklers
Generator _ Roof Pitch
Total Sq. Ft of Construction;
Sq. Ft. of First Floor: _
cost of Construction: utilities: —Sewer _ Septic
OWNED/I ESSEE:
CONTRACTOR:
Name
Address: Name:AUW 1R - ca
City: I Company: Rv
1
State: AddressAl
Zip Code: I''uP Fax:
Phone No� � Cif'' �• �!
E-Mail: • � ' Y zip Code: a
Phone No" MiAI
Fill in fee Simple Title older on next page (if different E-Mail
from the owner listed above' -NA um
Statc or Coun v t.icensc I
If value of construction is 2SOO or more, a RECORDED Notice of commencement is required.r
If value of HAVC is $7,s00 or more, a RECORDED Notice Of Commencement is required.
Lot No.
Block No.
— Pond
Building Height:
l{
' �' `� ` =�:■tea
SUPPLEMENTAL
CONSTRUCTfON LIEN LAW
".."., cm; Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER; _ Not Applicable
Name.
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _Not
Name: Applicable
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 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; ya ure to Record a Notice of Commencement may result in paying twice for
improvements to r prop . A Notice of Commencement must be recorded in the public records of St.
Lucie County a oste n t e jobsite before the first inspection. If you intend to obtain financing, consult
with lender o n a me be ore Commencing work or recording.our Notice of Commencement.
Signature of Owner ssee ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affir a ft�lscrlbed before me of
this day of �1Physical Presence or Online Notarization
r_ . _ _ 20Aby
Name of person making statement.
nally Known OR Produced Identification
M�d tificatio Produced
�\
of Not,ary Pnl lir
Commission No. "(7 f 6 (seal)
REVIEWS FRONT ZONING
DATE COUNTER REVIEW
RECEIVED
�oS?a: POet,
MARLENE LILT COLLADO
*
Commission# GG 171582
NyTFOFFO��`D�
Expires April 25, 2022
Banded Tf- Bcdget Notary 5orvic0$
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW
REVIEW REVIEW REVIEW
MANGROVE
REVIEW
Unico Air Conditioning Company
1711 Sunset Isle Rd
Ft Pierce, FI 34949
Phone: (772) 678-6676 Fax: (772)647-7525
Billing Address
Unico Air Conditioning Company
1711 Sunset Isle Rd
Ft Pierce,Fl 34949
(Shipping Address:
Terms of payment:
Term of delivery:
ipment ready for pick up at HD Su
Contract
Document Number 51007510350
8/30/2021
Caroline Johnson
Pine Lakes Preserve
7405 Pine Lakes Blvd
Apt 7405
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:
n �p
Ca�o�r O�Y1Shipping
Signature: Grand Total:
$2,200.00
$0.
$2,200
vawva.ahrrditt'Ctory.CryCertificate 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 R41 OA AC
Outdoor Unit Brand Name : TEMPSTAR2
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 ANSIIAHRI 2101240 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 (AP-) - Single or High Stage (9517), btuh : 22800 &A " M ■ i ■ = N M
SEER : 14.00 r
EER (A2) - Single or High Stage (96F) 1 f .50
t"Active" Modal Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale- OR now models that ara balms
marketed but are not yet being produced: Production Stopped" Model Status are those that an AHRI GertificallOn PrOgraR1 Participant IS no longer producing BUT is still
selling or otrenng for sale.
t s t t aJe_aceompanicd by WAS indiratP an mt���e ra he ne�ublisht d rahngts show long with theme e tous_(i.e. INAS) ratino.
DISCLAIMER —"`�— Lam"
AHRI does not endorse the produot(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 exprossly 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 Wwta,ahridirectmy.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,
personal —d confidential refer�n co. AM
CERTIFICATE VERIFICATION 4/R- ...rTrhulNtl. wri.-nNo-
The :nrorrr,anon for the muaei citea on this Certificate Can be verified at cfww.ahridlreetory.ora, click on "Verify Certifleate" link "aPRI06RATION INSTfrtrrE
and enter the AHRI Certified Reference Number and the date on which the Certificate Was Issued, az 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.: 131866200563162522�