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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 94o LLGL( L Building Permit Application Planning and Development5ervices 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: PROPOSED IMPROVEMENT LOCATION: Address:_; 1J� ice A5 1 Property Tax ID#:`-6C1`-5w'()"3 Q-lam' Ll Lot No. Site Plan Name: Block No. Project Name: 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 _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: /� ` Sq. Ft. of First Floor: Cost of Construction: S 2"1 11v Utilities: —Sewer —Septic Building Height: Pond Pitch OWNER/LESSEE: CONTRACTOR: Nam W Name: Y -i(ce e Addr s: C� Company: Y f U L�. City: ;� (. , State: Zip Code:._ Fax: Phone No. E- Ad ss%IlnV � ' Cit W Zip Code: , 'D-(,�Fax: Phone No )i - n _- State: Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail j f "I ' / . l State or County Li ense��C I D JLt !9 It 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: UL51GNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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. 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 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attornev before colmmencinE wnrk nr rPrni-dina vnur NntirP of rnmmanrpmonr Signature of 0 t / Lessee/Contractor as Agent for Owner STATE OF FLORIDAS^`1�'V n COUNTY OF l//jj U [ Swor (or affir d and subscribed bef re me of _ Physical Presence ori, Online Notarization this day of 20Ld by Rc�l� Marcell Name of person making statement. Personally Known OR aced Identifigation Typ f Iden ification Produced y/ S LACfi %-e. (Signature of Notary Public -State of Florida CATHERINE MILLER 73� ) f`°r 4'; State of Florida -Notary Public Commission No. I Seal '• •= Commission#GG273315 ,T' My Commission Expires November 01, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ,.e 1 / NOTICE OF COMMENCEMENT Permit No. State of Florida, County of St. Lucie Property Tax ID No. 1301-500-0346-000-9 The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Legal Description of property and address if available SPANISH LAKES COUNTRY CLUB VILLAGE LEASEHOLD ESTATES (OR 2389-639) THAT PART OF SEC AS SHOWN IN OR 2389-639 BEING LOT 19 SIERRA DEL NORTE General description of improvements Replace A/C System Owner/lessee George Winfield Address 19 Sierra Del Norte Fort Pierce, FI 34951 Interest in property: Owner Fee Simple Title holder (if other than owner) Address Contractor Comfort Experts USA Inc Phone # 772-873-3000 Address 664 NW Enterprise Dr. Unit 120 Port Saint Lucie, FI 34986 Fax # 772-873-3090 Surety Phone # Address Fax # Amount of Bond Lender Phone # Address Fax # Persons within the State of Florida designated by Owner upon whom notices or other documents may be serve by Section 713.13 (a) 7., Florida Statues: Name Phone # Address In addition to himself, owner designates Phone # Fax # Fax # AOTN3 mpr>n Opu�m AOarr o"Cr Z NOm Ohm M?a p N 0 3 aDNp .eoo=r gmNCA N o (1 to oe 0 0 W + m ti , m i; z c n � 0 0 c of to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CH.713.13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE SOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCMENT. Owner/Lessee, or Tder's or Lessee's Authorized Officer/Director/Partner/Manager/ Signature OWNER ✓/ Signatory's TItle/Office State of Florida, County of Saint Lucie %n� p Acknowledged before me this 24 day of September 2021 , by'.n'� M Ill d �[ is ersonally known to me or who has produced Y1VP(5 U(PXI' as identification. Catherine Miller---�--- Signature of Notary Type or Print Name of Notary s o CATHEERINE MILLE I-Y >F „'� State of f�ai�s-Notary Pu —t 2 �E Commission a GG 273315 Title: Notary Public Commission Number �Z 13 )i 5 'ago<,.d�.�' My Commission Expires ` ronar" November of. 2022 Eligible for Federal Tax Credit Certificate of Product Ratings AHRI Certified Reference Number: 201281646 Date: 09-22-2021 Model Status : Active Old AHRI Reference Number: 7941343 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RHEEM Outdoor Unit Model Number (Condenser or Single Package) : RA1630AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : RH1T3617STAN 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 RHEEM 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), WIT : 28600 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 published rating is shown alono with the Previous (i.e. WAS) rating. DISCLAIMER AHRI does not endorse the products) 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 forthe model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link �..e make life boner^ 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.: 132767937969365864