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HomeMy WebLinkAboutPalerm appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 10/8/2021 Permit Number: �;,-n LU CU1� _r1, 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: Replace a 5T AC system PROP0S ENT LOCATION: Address: 12745 Refuqe Lane Jensen Beach FL 34957 a Property Tax ID #: 4507-702-0006-000-6 Lot No. Site Plan Name: Juan and Maria Palerm Block No. Project Name: Flynn's AC Services DETAILED DESCRIPTION OF WORK: Replace a 5T. 16 seer AC system with a 10KW heater New Electrical Meter Second Electrical Meter EONSTRIICT]ON INFORMATION: (Affidavit required) Additional work to be performed under this permit — check all that apply: XMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 7500 Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Juan Palerm Name: Joseph Flynn Address: 12745 Refuge Lane Company: Flynn's AC Services city: Jensen Beach State: FL Zip Code: 34957 Fax: Phone No. 786-624-9741 E- Address: 1323 SW Thelma St City: Palm City State: FL Zip Code: 34990 _ Fax: Phone No 772-283-4114 Mail:- com �nalerm19694gmail Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail mjb(cDflynnac.comcastbiz.net State or County License CAC055482 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. DESIGNER/ENGINEER: 2�, 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: XNot 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. I 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 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 attorney before commencing work or recording your Notice of Commencement. Sign re of'Owpo-'F/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Savor to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of G W 20;-( by Name of person mbking Personally Known OR Produced Identification Type of Identification produced (Signature of Notary Public- S> to of Florida ) Commission No. _ 33.x 7 (Seal) REVIEWS I FRONT COUNTER DATE RECEIVED DATE COMPLETED ZONING REVIEW MicMie J. Brown Notary Public z f-State of Florida = COMM# NHO43373 Expires 10/1/2024 SUPERVISOR I PLANS REVIEW I VEGETATION EVIEWI S REVIEW LE MREVIEW VE Eligible for Federal Tax Credit AHRI Certified Reference Number: 8902721 Date : 10-08-2021 Model Status : Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC7B6021 Indoor Unit Model Number (Evaporator and/or Air Handler) : AE60DX21+TXV 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 CHAMPION HEATING AND COOLING 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 : 57000 SEER: 16.00 EER (A2) - Single or High Stage (95F) : 13.00 f"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 prod uced."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 along 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 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, AM 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 ( CERTIFICATE NO.: 132781738329777065