HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Plonning ond Development Services
Building ond Code Regulotion Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7721 462-1553 Fax: (772) 462-7578
Commercial Residential
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED I M PROVEM ENT LOCATION :
Address: 3702 Highway 41A #1 103
Property Tax lD #:
Site Plan Name:
1423-807-0040-000-1 Lot No.
Block No.
ProjectName: Polinsky-Residence
DETAILED DESCRIPTION OF WORK:
Like for Like HVAC System Replacement Water Source HP System- 14EER- CLOSET
4 Ton
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_lr4echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Generator _ Roof _ PitchElectric_ Plumbing _ Sprinklers
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction: S 6483.00 Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name Ronald Polinski
Address:
City:
Zip Code:
Phone No.
Mail:
Fax:
E-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
'1716 Maqnolia CT
Name: Don Miranda
Company:Miranda Plumbing & Air Condtionir
Address: 750 NW Enterprise Drive
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
phone No 772-878-5123
E-Mail Ldiodato@miranfacompanies.com
State or County License CAC1815486
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address;
City:State:
zip:Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:State:
Zip: _Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
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.
Str Lgcie County.makes no repre.qentation tha!is grantjng a permit will authorize the permit holder to build the subiect structurewnlcn ls ln conlllct wlth any appllcable Home Owners Association rules, bylaws or and covenants that mav restrict rir prohibit suchstructure, Please consult With yiour Home Owners Associatioh and ievi6w'yorli deed ioi ahyi i*triitidri; vitiiih-iniv ailpIv."-'"
ln consid.eration 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
.IWARIIIIIIIG TO OWNER: YOUR FAITURE TO RECORD A NOTICE OF COMMENCEMEI{T MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTTCE OF CO}IMENCEMEIUT MUST BE RECORDED AND
POSTED OIU THE JOB SlrE BEFORE THE FrRST INSPECT|ON. lF yOU TNTEND TO OBTAIN F|NANCING, CONSULTwlTHYoUR.IF4lQ!:RoRANATToRNEYBEFoREREcoRDlNG@EilcE|llENT',,
/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY Qpstt-ucie
The forqoing instru--ent was acknowledged before me
Name of person making statement.
Personally Known xxx OR Produced ldentification
Type of ldentification
of Notary Public-
frlnmission # GG(
Expires: Feb. 9,
Sign NUffi'ntra ctoi/Lice n se H o lder
STATE OF FLORIDA
COUNTY Qlstt-ucie
The forqoing inStrumo^t ,^'?s acknowledged before me
Name of person making statement.
Personally Known ux OR Produced ldentification
Type of ldentification
Produced
(Signature of Notary Public-)
FRONT
COUNTER
ZONING
REVIEW
RECEIVED
9ertificate of Product Ratin
AHRI Certified Reference Number: 562g634
Old AHRI Reference Number :
Product : Water-to-Air and Brine-to-Air
Model Number : TWHO4g
Brand Name : TRANeUtLtTy 22 DIGITAL
where rating shows value/value. the first value is at minimum voltage, the second value is at 23ov for a dual volt system.
tModels with "Discontinued" Model status are those that an AHRI certification Program Participant no longer produces AND is no ronger selling or offering for sale.
DISCLAIMER
AHRI does not endorse the product(s) listed on this certiiicate ancl.makes no representatiorls, warranties or guarantees as to, and assumes no responsibirity for,
unauthorized alteration of data listed on this certificaie' certified ratings are valid only for models and configurations listed in thedirectory at www.ahridirectory.org.
TERMS AND CONDITIONS
This celtificate alld its contents are proprietary proclucts of AHRI. This certificate shall only be used for individual, personal a,rdconfidential reference purlloses. The contents oi tlris certific;ie may not, in whole or in piit, ne reproclucecl; copiecl; disseminated;
;:::::X#;r,"::TjJjililJ#,i.,i;1,*herwise utirized, in any-rorm o*un,i"foi ;y;;;;;;;,, except ror the use.s individuar,
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on ,,verify certificate,, link
3ll1"ii:1",51111.!.ll'll:gl:tl:.1.: Number arld.the date on which the certificate was issu&,which is listed above, and the Certificate No., which is listed aibottom right.
@M1Air-Conditioning, Heating, and Refrigeration lnstitute
Rated as follows in accordance with the latest edition of ANSI/AHRI/ASHR.AE/ISO 19256-l Water-source heat pumps -- Testing and ratingffi!"Jtffiffi1. Part t: water-to'air and Brine'to-air heat pumps
"na "uui""i to rating accuracy by AHRt-sponsored, independent,
Date:09-23-2021|Model Status: Discontinued
Part Load3
Air Flow Rate - Cooling:
Air Flow Rate - Heating:
WLHP (Water-Loop Heat pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuh/watt)
Cooling Fluid Ftow Rate (gpm)
Heating Capacity (Btuh)
Heating Cop (watt/watt)
Heating Fluid Flow Rate (gpm)
GWHP (Ground Water-Heat pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (BtuhA&att)
Cooling Fluid Ftow Rate (gpm)
Heating Capacity (Btuh)
Heating COP (watt/watt)
Heating Fluid Ftow Rate (gpm)
GLHP (Ground -Loop Heat pumps)
Cooling Capacity (Btuh)
Cooling EER Rating (Btuh/Watt)
Cooling Fluid Flow Rate (gpm)
Heating Capacity (Btuh)
Heating COP (watt/watt)
Heating FIuid Flow Rate (gpm)
lndoor Blower Motor Fan Type : ECM
Sold ln? : USA
Full Load
1 500
45900/45900
14.00t14.00
12.00
53800/53800
4.90t4.90
12.00
51 800/51800
20.90t20.90
12.00
45000/45000
4.40t4.40
12.00
48100i48100
15.50/15.50
12.00
35600/35600
3.70t3.70
12.00
Part Loadl
1250
1250
341 00/34100
15.20t15.20
11.00
39500/39500
5.50/5.50
1 1.00
39200/39200
26.80t26.80
1 1.00
32600/32600
4.60t4.60
1 1.00
37600/37600
21.20121.20
1 1.00
29200t29200
4.10t4.10
1 1.00
Part Load2
AIR.CONDITIONING, HEATING,
& REFRIGERATION INSTITUTE
rvc ttrke life bettcr,',
CERTIFICATENO.: 132768e877s62001e0
AllPl crRTrFrED'
www. ah rid irectory,org
Michelle Franklin, CFA - Saint Lucie County Property Appraiser - All rights reserved.
Property ldentification
Sic Addr6s: 1702 N ln(inv,\YAIA I 103
Sccnown/Rango: :1/l45/401:
Pffcel ID: r4t!807,@Gmo,r
Iuidiclion: Salil lxcieftunty
ownership
C.mq U.ilc)l Ih le06o-6819
Legal Descriptlon
(iRAND lst-ll of NoRTtl lllJ'rcHlNsoN ISLANDcoNDoMINtrIM loR 1211-l t90) uNlT I t0l()Rlrt7-9051
Current Values
Mrf II): r4 lls
Total Areas
FiDiJrcd Undcr Air (SF):
(no\s Stclchcd Ar.il (Sr)l
Property taxes are subject to change upon change of
ownership.
l'u{ r!\0\ !renor i fulliIk rrnitcrnD ofrrhrre rr\es,
I [. \rlr ilf r fr,t\ il \ill p,nrilnr rh. ', trrr ul orrll, s nrII(rttr, rtril !,((lrl (lJrrifi(Jriun\.
T.\cs tbr ilrli f!(cl: sl ("rix (ullNrur'\ oni.. A
Dorvnl,ad TIIIM lbr 0ris pnr(eli IIN|L'il rl)1, A
Building Design Wind Speed
o.cupanclCatcgort I Il lll & lV
Sp(cd l4o 16(r l7o
ll nrnnnrilnu i\ hdicwd io be corccl d ilris lirc. hu( is $rhicd n) cIiltrg! itrd Ls pro\ nld lviilutr !n) \rrnilnr
o (i,pyrishr 20ll Silinr Lfcic (iNnrr Pn,pcny
^ppriil.r.
All rishr5 r.sc^cd.
CITY OF FORT PIERCE, FLORIDA PERMIT#
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
(7 72) 467 -37 18 F AX (7 7 2) 467 -3849
IIu iId in s.t?l)cit.yo I'lirltpicrcc.conr
FBC (2020) 7th Edition
PIN #
*Property addr.., !702 I A1A #1103
parcer rD# 1 423-807 -0040-000-
(Located on your tax bill)
xOWner \669 Ronald J Polinsky
Phone# (772 )878 - 5123 F
Building Department Proj ect Manager:
*Owner Address
L---J
*ea1" 912712021
*# of plans submitted _* # of CD's submitted_
1716 Magnolia CT Garnet Valley, PA 19060-6819
Cell # (_)
Email Addres, Ldiodato@mi
*Required Information
TYPe of Permil Mechanical *Valuation $ 6945.00
*Des*iption of work: Like for Like HVAC Replacement
Water Source heat pump System- 14.EER- Closet -4 ton
Architect:
Phone(-)---Fax ( )Email Address
Engineer:
Phone(-)---Fax (-)Email Address
*CONTRACTOR/APPLICANT INFORMATION:
City License #State L a CAC1815486
company11u.. Miranda Plumbing & Air Condtioning Don Miranda
Address 750 NW Enterprise Drive
Phone # (772 )878 - 5123 Fax # (-)Cell # (_)
Email Addres, Ld iodato@m i ranfacom pan ies. com
Occupancy Construction Type # of Units # of Stories
Sq. Ft. Conditioned Space Total Sq. Ft.
I understand that no building may be occupied until a Certificate of Occupancy/Cerli of Completion has been issued after
final inspection by the Building Department and full compliance with the building codi, city ordinances, state statutes and other
applicable rules and regulations have been satisfied. I am also verifying that all sets of plans subrnitted are identical.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certifu that no work or installation
has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells,
pools, furnaces, boilers, heaters, tanks, and air conditioners etc,
Owner's Affidavit: I certify that all the foregoing inforrnation is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
Pagel of2
Zip