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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�k Pafrd y?o r I is W is- Add iti al warfc to be performed under this permit —check all that apply. _,Mechanical — Gas Tank . —Gas Piping ,_ Shutters �- Windows/Doors - Electric — Plumbing ,,,,_,,, Sprinklers - Generator r,,,_, Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $T 7 . 0I? ' Sq. Ft,. of First Floor: Utilities: —Sewer ,,,_, Septic Building Height: Name J Addre s: (7 d0 inla d� [[ � City: state: a Zip Code: Fax: Phone No. E-Mail: Fill in fee simple 'Title Molder on next page ( If different from the Owner listed above) Name, JAMES F. GRIMES Company: GRIMES HEATING AND AIR CONDITIONING Address: 3054 N US HWY 'i City: FORT -PIERCE State: FL Zip Code: 349446 —� W Fax: 772461-8722 Phone No 772461-8711 E-Mail ROBERTGRIM SAC@a AOL.COM State or County license 4426 f value of construction Is $2500 or more, a RECORDED Notice of Commenceniant Is rat f va fue of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required. Name:. Address. city: Late: ZIP: ' ' pn . FE9 SIMPLE VnE HOLDER; . �.�. Not Applicable Address: �.�� ,�....��.,.,• ZIP'.._ Phone MORTGAGE COMPANY., ...�, Not Applicable Zip: ��.hdrrn�. _... _Not Applicable Name; Addrer;�,^._�.�..�._.� .�.�.. OWNER/ CONTRACTOR AFFIDVIT.- Application I,a hereby made to obtain a permit to do the work and Instalintkrn a.i Indicated. I certify that no work or installation has commenced pdor to the issuance of a penult. at. Gle wrrt mai mo rep a trtion that Is rmn " a rteYrnit 11ii rr rt toriarr their armit holde to build the rub ect �� sro ugh c sin orr Ict w ti a��r �►% e Ilrrre ravers s, a rr on ru yawrsr eaovens�nts t�i t may re cr1r.t rar+a stricture. prlmese consult wit i our ome wners sseclat orr and rr+�u +sw yo�ir ee any restrict ons whit i may a ply, In consideration of the granting of this requested permit, I do hereby agree that I wJ14 In all rasped, paribrm the work In accordance with the approved plans, the floridn luilding Codes Intl 5t. Lucie County Amendments, The following building permit applications are exempt from undergoing a full concurrancy mvlew; room ardkions, accessoeystrur tuns, swrimmIng pools, fences, walls, signs, screan rooms and mccassrrry uses to another non-residential use "WARNNG TO OW"W" YOUR FAULURE TO INCOND A NOTICE OF C0NMWCMN= MAY RESULT IN YOUR'PATING POST ON THE JOIS SrM MORE IRE FIRST MPECIVON. IF YOU INTEND TO 'WAIN FWANCINCy CONWR '` WITH '! oup Munro no AM fAWC n"W aftwnftow ,",ftffmft4w %Pmidara r► 5 ature of omrrrJ Lpss��r/Corltr Gtnrr�s A fors Owner STATE OF FLORIDA COUNTY O The fnraning instru, nr•, � as nQ iedg'e befrrro iYR,•�, r� T.. •th1c ;,ydayof ! o., o_ Icy 4W�S rtr�y�Q Nome of person making state+nent, Personally Known � OR produced Identlikation IVPe of idendoca , an Rrorlucrd,,w...� Commission � �' REVIEW!; l�i�Ciil T rIJIV7El� ll*VIEW MON'MN1-(4R0 )SION # GO 080 REVIEW ic .xruw'w�Mwitiw Y � x,w.�..w rr.rw•�..Mr+...i�n S argeyr�rrtC�rnttrgagcytor/tIcense holder STXp 4MINIRM'691 if 0Y'— The fo ralrr instrurme was ckrrowled d before me this '� d ' al � �I , 2Q�?I by Narmo of parson rmeking statement. Personally Known "� � OR Produced identific.0on- .. TVpo of Identification M � � 3: Sl♦� AHRI Certified Reference Number: 8908428 Date : 09-23-2021 Model Status: Active AHRI Type: HRCU-A-CB (Split System: Heat Pump with Remote Outdoor Unit -Air -Source) Series : XR14 Outdoor Unit Brand Name : TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TWR403OG1 Indoor Unit Model Number (Evaporator and/or Air Handler) : TEM4AOB30531+TDR The manufacturer of this TRANE 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 : 28000 SEER: 14.00 EER (A2) - Single or High Stage (95F) : 11.50 Heating Capacity (H 12) - Single or High Stage (47F) : 27800 HSPF (Region IV) : 8.50 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 Slopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for safe. Ratin s that are accom an€ed bv WAS indicate an involunta re -rate. The new oublished ratins is shown alona with the revious i.e. WAS rating. DISCLAIMER AHRI does not endorse the product($) 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; 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 verlfled at www.ahridirectory.org, click on `Verify Certificate" link wte 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. e@2021 Air -Conditioning, Heating, and Refrigeration Institute 1 CERTIFICATE NO.: 132768824583854493