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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll ARPL! BLE IN OMM(U�/STT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' lU M Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: N\t UA � PROPOSED IMPROVEMENT LOCATION: Address: h S � 4 U �1,t �1 Property Tax ID #: Alt - S- p `Q ` 00 O l - 4 U 0 - tic Lot No. Site Plan Name: ,� p Block No. Project Name: �` III, `jMM MyNit DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: _Mechanical —Gas Tank _ Gas Piping i Shutters _ Windows/Doors Pond _ Electric _ Plumbing — Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: O W N ERAESSEE: CONTRACTOR: Name 1 V Name: Address: 1 Q Company: f ti 1-b City: State: MA uu Zip Code: L Fax: Phone Nolnr . il Address:111` Myt q a City: b - fku n. Stater Zip Code: -1�-�1n9_11Fax:I1�, gal .h' Phone No l l n• r1�F) . C;I®y "Y\ E-Mail:'; Wu1b11jh----Q--i )( q,1�s� Fill in fee simple Title !Holder on next page (if different from the Owner fisted above) E-Mail t State or Coun r License 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: Address: Address: City: State:_ Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER; _ Not Applicable BONDING COMPANY! Applicable Name: _Not Name: 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. 1 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 ail 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 improvement your operty. A Notice of Commencement must be recorded in the public records of St. Lucie Cou po ed n the jobsite before the first inspection. If you intend to obtain financing, consult with len er tto e before COMMwork or recording our Notice of Commencement. Signature of Owner Contractor as Agent for Owner STATE OF FLORIDA q COUNTY OF Sworn to (or affir ed and Su scribed before me of "� Physical Presence or Online Notarization this" day of 201:\ by Name of person making statement. Personal OR Produced Identification Type of nti 'ca ' Pr d ed (Sign atu of Notary Publi tat e of Florida) Commission No. t7 {seal} �o� Y��elc MARLENE LILI COLLADO * Commission # GG 171582 IkExpires April25,2022 ,volif'o-6, FOPWddTrwBudget Notary servi= REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 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 9/21/2021 1711 Sunset Isle Rd Ft Pierce,Fl 34949 Shipping Address: Caroline Johnson Pine Lakes Preserve 7638 Pinelakes Bluvd Port Saint Lucie 772-245-4530 Terms of payment: Net 1S Days Term of delivery: ZORWOB Origin) Equipment ready for pick up at HD Supply Item Material/Description Quantity Unit Price Amount 1 Install Indoor/Outdoor AC Unit 1 $2,200.00 $2,200.00 Int. Article No. 25937855 2.5 ton Goodman 14 seer R410 Subtotal: (J (� j(� Tax: �J�V �Y 19 Shipping Signature: ` 1 Grand Total: $2,200.00 $ A $2,200. Certificate of Product Ratinas AHRI Certified Reference Number.- 201200012 Date : 03-30-2021 Model Status : Active Old AHRI Reference Number: 7516442 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series : GSX14 Outdoor Unit Brand Name : GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX140311 K* Indoor Unit Model Number (Evaporator and/or Air Handler) AWUF31XX16A* 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 GOODMAN 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) 12.20 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 published rati_nais shown alone with the previous (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 --"12-' confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; `.. r� 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 1 CERTIFICATE NO.: 132615886503512066