HomeMy WebLinkAboutSmith PermitAll APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION! TO BE ACCEPTED
Date: 10 Permit Number:
(M LUCE
L'�ii�i
V 1b @ 1V v 5 n -�`" = 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax I D #:45V - -I ba- 00 ! a' - 000d Lot No.
Site Plan Name: S Ml -i Block No.
Project Name: _ SM.I
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: i
Cost of Construction: $ 4, t �[ `.
Gac piping
Sprinklers
_ shutters _ Windows/Doors Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Names-re-\jein 3 sml-Fkn . r.
Name: i)oup,
Address:1Og90 S. ocean dr. i'li<
Com an lns�F r
p v CUui A
City: SQ"Se r\ b-P-CI.C30% State: L.-
_%
Address:
C +
Zip Code: 34 Fax:
City:
State: F C.
Phone No.33® - 19 M a►o110
Zip Code: -SL4QF -�
E-Mail:8iSgndSons 2. @4mal� • Cpm
Phone No C71"1)
E-Mail r� Chi rtt'1+a c;� ab r`.6r^
Ff�^^� �; . C •
Fill in fee simple Title Holder on next page (if different
State or County License
from the Owner listed above)
If daiue yr conscrucuon is z5uu or more, a Kt1LUKL)tu ivotice 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.
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 that
covenants 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 our Notice of Commencement.
z7. ,�
47.,.� • 2.
Signature of Owner/ LATe / ontractor as Agent for Owner
Signature of Contractor License Holder
STATE OF FLORIDASTATE
COUNTYOF�S T. LLACle
COUNTY OFORIDAST. L uCIP_
Sw rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of b[ c� [202q by
Physical Presence or Online Notarization
this 22 day of 0C - L-Q pT—f�.r" , 202d by
mQS
Name of per n making statement.
Name of person making statement.
Personally Known �1 OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Pro uced AMAND;AD.BOIS
:�. MY COMMISSGO 17
A o: EXPIRES. 22, 2ci
ature of ta Public- St
Nory
(Signature of Notary Public- S
<�Y.?fie: AMANDADUBOIS
Commission N I`jbU�
Y OMMISSION # GG 17
+: -IS aI:XPIRES:ApdI22,20
804
Con ission N (Seal)
FOF Ft° ` Bonded Thru Notary Public under
' t5
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
Eligible for Federal Tax Credit
Certificate of Product Ratings
AHRI Certified Reference Number: 8881390 Date : 10-22-2021 Model Status : Active
AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower)
Series: LX SERIES
Outdoor Unit Brand Name: LUXAIRE
Outdoor Unit Model Number (Condenser or Single Package) : TC7B2421
Indoor Unit Model Number (Evaporator and/or Air Handier): AVC24BX21+TXV
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, H1, 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 LUXAIRE 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 : 23600
SEER: 17.50
EER (A2) - Single or High Stage (95F) : 14.25
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 along with the previous (i.e. WAS) rating
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 %Ne 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. ------ - --- -- -- -- -- ---
002021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132793952202246508