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HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
,r
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: 4 UA C c- / a 2c o
PROPOSED IMPROVEMENT LOCATION:
x
Address: 25 •I/ r2 /l 1�1�-e•� -�D r-� P / +° rGQ
Property Tax ID #: 1 y&Q �3 51- /2©© Lot No.
Site Plan Name: " -�P. y'4 ��S Block No.
Project Name: ZLe/9
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additio ork 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: $ '/i0 a
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C ae(�X, 1 d o f C
Name: & il' n
Address:
Company: �� s5 �h a
City: e'-G( State-_
Address d03 S'G-` 34� �cLru
State:
Zip Code:5V!2 :i�q Fax:
City:1�9 gfe/ �449t
Phone No.:Z,22-�iZ�-� !7 5-- E-
Zip Code: �5 9 7y Fax:
Mail:
Phone No _5Ze c;P.�2 - 3=2 7 /
Fill in fee simple Title Holder on next page (if different
E-Mail/l���rr�l ��/.�,� L' G� �,��c; /•Ca.�
from the Owner listed above)
State or County Licensee/6 7S'51
If value of construction is 2500 or more, a RECORDED Notice oT c.ommencememt is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
N LAW INFORMATION:
SUPPLEMENTAL CONSTRUCTIO
DESIGNER/FAi[.tntcri
Name:
Address:
City:
Zip- Phone
Applicab
State:
FEE SIMPLE TITLE HOLDER: Name: v'Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Name: Not Applicable
Address:
City: State,
Zip: _________ Phone:
BONDING COMPANY• -!�_
Name:
• _Not Applicable
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,
St. Lucie Count 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 concurr•ency 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN_-EINAMCING, CONSULT
WITH_YOUR LENDER OR.,AFU ATT Y BEFORE RECORDING YOUR NOTICE �OF COMMEN ME ."
Signature of
as Agent
STATE OF FLORIDA _
COUNTY OF %%') /fi fL-77
The forgoing instrum nt was acknowledged before me
this day of ©C 20:�"Z, by
Name of person m7711
ment.
Personally Known Produced Identification
Type of Identification
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF f%1i�Jr�%I
The forgoing inst_rum n was acknowledged before me
this3� day of Li�a� 20j� by
Name of person making st ement.
Personally Known 'OR Produced Identification
Type of Identification
Pceducc rl
(5ig, ature of Nota y Public- State of Florida) f
(Sign b
Com issio n.2 ,; , sw=ey °u !,C - State o CORI 5
+< Corrmiwor - GG :Florida3 t 5466
r. MyCD2rr.:�pnes —a n.Z023 — --
REVIEW ' ��s^. 11 r Assn. SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
)ATE -- - —
ZECEIVED r
ev,
ti
e of Notary ublic- State of Florida )
KELLIE J, Sw; ET
,40tAry 20lit - StatC' of Florida
IANGROVE
REVIEW
Certificate of Product Ratings
AHRI Certified Reference Number: 202717824 Date : 10-28-2021 Model Status: Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Outdoor Unit Brand Name: ARCOAIRE
Outdoor Unit Model Number (Condenser or Single Package) : PAJ430"`K"'B'
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 ARCOAIRE 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 : 28600
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.50
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 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 CONDITIONSall
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;A""""M N
entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AIR-CONDITIONING, HEATING,
personal and confidential reference. & REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link ,,c ,,,,,I;,. hli• bri irr
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. 132799110748610513
©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: