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HomeMy WebLinkAboutDayball permit application and AHRIAll APPLICABLE INFO iMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� LQ (cam 1 Permit Number: ..:.�. . �, J � l� 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 CBDG Funding PERMIT APPLICATION FOR: Ll Y e . C G 1e 'PVC clha ._COQ - PROPOSED IMPROVEMENT LOCATION: Address: -�x Property Tax ID #: " �(�� �— c�8 �CC�y� Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: J ��an i� Seer l-4-� 8 �.w, New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: (Affidavit required) Additional work to be performed under this permit —check all that apply: VMioechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 22, Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name i Name: Cky,i ft Address: Ey� (V\,V c-�Ve V Company: _A� (l�\ I I V f , City: • State:� Address: _I5`3t-� 'C EQM8YI Zip Code: a[�� Fax: ss City: ,v S L_ State: 1=-( Phone No._`1� s y (�t-I •_ 91 E- Zip Code: 3LIC1 Mail: Phone Norma—y_bl'- Re)�;L Fill in fee simple Title Holder on next page (if different E-Mail ii1 �i.�_sct�lS Ccpak.CCnYYI from the Owner listed above) State or County License C_n C: I sou \(�'© it value of construction is Z500 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 CONSTRUCTION LIE LAW INFORMATION: SIGNER/ENGINEER: _ No pplicable MORTGAGE COMPANY: _ Not Appli e Na e: Name: Addr s: Address: City: State: City: State: Zip: Phone Z Zip: P ne: FEE SIMPLE TITLE H _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City City: Zip Phone: _ Zip: Phone: WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as ' `ated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is grantin a permit will authorize the permit holder to build the subject structure which conflicts with any, applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 C unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with er or an attorpey before commencing work or recording our Notice of Commencement Signat re of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of � Physical Presence or Online Notarization this r�ll�.(" day of _�.. 202,L by Name of person making tatement. Personally Known � OR Produced Identification Type dentification ProduFd - n ture of No P blic- State of Flor' Commission No. IUt '-`jSealj td`�" '•• VJA ASHI,EYKENNEDY Notary Public -State of ftortEa Commission # HH 101965 My Comm. Expires Mar 23, 2025 Bonded through Eligible for Federal Tax Credit Certificate of Product Ratings AHRI Certified Reference Number: 205847114 Date : 09-16-2021 Model Status : Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RUUD Outdoor Unit Model Number (Condenser or Single Package) : WA1624AJ1 Indoor Unit Model Number (Evaporator and/or Air Handier) : WH1T2417STAN 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, SD, 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. The manufacturer of this RUUD product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 2101240 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 : 22800 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 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 ublished ratinq is shown along with the Drevious (i.e. WAS) ratina. 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 individual, personal and confidential reference purposes. The contents of this Certificate may not, In whole or In part, be reproduced; copied; disseminated; Masi 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 for 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 I CERTIFICATE NO.: 132762750942896360