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HomeMy WebLinkAboutCORBETT AC CHANGEOUT PERMITAll APPLf4BLE 11R-FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ?J Permit Number: LUC E 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: PROPOSED IMPROVEMENT LOCATION: V-P A-10- OWANIC Address: r rr,,V) i Property Tax ID #: • V O r ­7 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter KNSTRUCTION INFORMATION: (Affidavit required) Lot No. Block No. Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ U4 OWNERAESSEE: Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: Name ► ► 7 I Address: n City:wolf— State: f Zip Code: �11�1 Faxes: j Phone No. 1 Z' U-7' J I S E- Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Name: M110 N Company:M Sal T Address: RIF), S�City: f State:, Zip Code: 2- px: Phone No 11 Z • 4U • 91 E-Mail lcyi S fit, QJ n 1 Scot— - Corn State or County License -1 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: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: 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 C^nty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with I n r or an torney before commencing_ work or recording your Notice of Commencement. Signature Af Owner/ Lessee Contractor as Agent for Owner STATE OF FLORIDA ��. COUNTY OF Sworn to b�scribed bef ✓ Physical Presence (or affirTed) nd sy re me of or Online Notarization r3CV thisday of , 20f by ?h1h SCA J�_ Name of person makingstatement. v/ Personal Known OR Produced Identification Ty e of I enti ation duced (Si na ure of Notary Public- State of Flo �ii 'Seal) `tipAYPUBi KRISTIN BAITSHOLTS of Florida Commission No.66 !� / �° :State -Notary Public Commission # GG 278527 MY Commission Expires February 15, 2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 1 Eligible for Federal Tax Credit Certificate of Product Ratings AHRI Certified Reference Number: 203374606 Date: 09-30-2021 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: MERIT ML14XC1 SERIES Outdoor Unit Brand Name: LENNOX Outdoor Unit Model Number (Condenser or Single Package) : ML14XC1-036-230C** Indoor Unit Model Number (Evaporator and/or Air Handier): CBA27UHE-036-230*+TDR 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 regionaFefficiency-requirement. The manufacturer of this LENNOX 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 : 34600 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. Retinas that are accompanied by WAS indicate an involuntary re•rate,. The new published retina is ahown alona with the Drevious (i.e. WAS retina. 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 disclaim all Ilablihy 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 Certlllcete. Certified ratings are valid only for models and configurations listed In the directory at www.shridirectory.org. TERMS AND CONDITIONS This Certflcete and Its contents are proprietary products of AHRI. This Certlflcete 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; sow .� IL 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-CONDMONING, HEATINR, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at .: r;:;, •- t :o: ;. click on 'vr,rlfy c©rt I Ilcat e" link wi make fit , ,n and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which Is listed above, and the CertMcate No., which Is listed at bottom right 02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132774777263238267