HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 12/27/2021 MON 13: 27 FAx 772 3367566 AC Advantage, ine. 2002/004
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date o2 � Permit Number:
t?q)llo Lu
'fb\U; k.1• v
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;
i.. :�nnr. ,�d, , i ei 7...r ,r. .;. ..i, : �2• '+`aV , 1•• +';r,r flJis: 1r L'ft7:n F•,�:,,fa'{l:'t i� 8;
,L �rs+.rKL��,yy, ���cp7 � t, 1'yr}'� ,,L�^ r�.. xb'A,.A� l, r 1' �NE�,. •��}�i,:,�`1r �y�,y; � _q y,L ti1LI• '��
�:.I�,r'r�CvLv'�!yY��,�I' .��:;Y",�IYI�l����LY,�'. ;1'IYJ.�;.���w �'t!�42 �".Jp41r� y �7'f� �'`.�( hlt;�l ,•lae,'a r•`�'.t,�'+X�l�i+�:;�:�"1"ri.�`t 3,k`' '3
I�':, �r'.dSr.. �� �:`�:J.r:ZjY[,...:a:'.: �: .5�.'• nyav'}n :•s:�,h. 4Y`rM��i.a 5.
Address:, �I/OIIn Cl,1�.14 �a
Property Tax ID M ~ ��� •— (]b� OCR — Lot No. k
Site Plan Name: Block No.
Project Name:
I WE
New Electrical Meter Second Electrical Meter (Affidavit required)
PEA � 8 i r ,; •°r2 f, a ,' 1
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:
,4 Sq. Ft.of First Floor:
Cost of Construction:$_ �•C\ Utilities: —Sewer —Septic Building Height:
Name Name: � AA�-�`� (�1 l V4--•
Address: Company: [' t�
City: State:_ Address:1 � f.�.�� �` V.�S1sL '�'
Zip"Code: Fax: City: �Ja--C,.�''� State:
Phone No, E- Zip Code: -t Fax.I :�:P� (-(
Mail; Phone No
Fill in fee simple Title Holder on next page(if different E-mail C S1- CGVGU}— C LAC . C.n
from the Owner listed above) State or County License <::�MG• 12_4,97' -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.
12/27/2021 MON 13: 28 FAX 772 3367566 AC Advantage, inC. f�j003/004
•s, . .., Diu •'„:"r:,w, ' .;.) '.:'��, i.•";:,a.�„ 'S.1�''.: - , :• .
LPL >,,,,. " :;•:.',
�-M, Ef�T�4L CONV5'T Urs'�'I( hl:,l.lA' IO.N y'�' :.i" °'Y,,•. '
n� ��.,'V; .i;`!; ,i.�•1 .:�••.,, �.r ,. . '~"1* 'S::••':h(�l,!•":;v• v;:+. uj,:;.•:(.:';i'••, ;•�; ,t•.',. �••y'y:�,,..;,i:
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 woric or installation has commenced prior to the Issuance of a permit.
St,Lucie County makes no representation that is ranting a permit will authorize the permit holder to build the subject structure
which conflicts with an applicable Homeowners%ssociation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consu,t 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing,consult
with Wrider or an attornev before commencing work or recording our Notice of Commencement.
nature of Contractor-or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Sworn to(or affir ed)and subscribed before me of —Physical Presence or Onllne Notarization
this 2, day of 20 2l by
Name of person making statement.
Personally Known 1,_OR Produced Identification
Type of Identification P o ced
(Slgnat a of Notary Public-State of Florida)
1 y Jamie Perna
Commission No.Q42- 3Z3(seal) NOTARY PUBLIC
STATE OF FLORIDA
Commk GG267323
Expires 10/28/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
I
12/27/2021 MON 13: 28 FAX 772 3367566 AC advantage, ine.r%ommal CERTIFIED'
f�00a/OOa
r
Certificate of Product Ratings
AHRI Certified Reference Number;202678490 Date: 11-30-2021 Model Status:Active
AHRI Type;RCU-A-Ci3(Split system:Afr-Cooled Condensing Unit,Coil with Blower)
Outdoor Unit Brand Name.,ALLIED
Outdoor Unit Model Number (Condenser or Single Package);4AC16L41P.50
Indoor Unit Model Number(Evaporator and/or Air Handler):BCE5C42M"4X
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,OR OK,OR,PA,Rl,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.Baginning July 1,2016 central air conditioners can only be installed In reglon(s)for
which they meet the regional efflelancy requirement.
The manufacturer of this ALLIED product i6 responsible for the rating of this system combination.
'r, T'�,,-.. -- ,.I,B•7 ii !•,1.1`' -.,l;r i•n :1•'r x,�r1'ISe•LV�. ibl:"'�Pi r:t- F: N J��1r. 1 11n•.gLn t. ,.! "�;rt,,S,Le('.i,';�" .y:1;r,:r.=h:!r„ r�:..�;' 1 i�'��: I '� _r,� r,�>'•:,,
�! A,w ,��1 �,
,$ r7 ' Y.�"yr Y'J�.�•dv,.•;71 t •• •6JY�gf'i J�PTE t �,Y•1 t.
r �1 q>'i1t,/T Yk "@N t�y „� 4}lr. 7• _ E� S'g�4n,. !c � r n 4
Ret9d 9' 1�1 m; ":t d 1 'lest,egltlo'Yil dfIWlil l'a1'07 W p' •It" , >�, t
&Air-Sp c �ayaI Punip a �ulpm and ubje, tQ rating aci
4
Coolin t�7 bt I,3TO1h ! 1. •', .S. 1.+�'ry •nv' .,i�,. ) .:' .�Swul,!k,1�`` ' h �1
SEER'r' Fy igX1 trt1 5 A 4� .,• ti1 'Xli 1j�i7 T i d IY 'iY K'ti0% C Ir
EER , t'�fi ���i� •ro='r '�'��,
E'1 ! y w1 �+, i ,�? '�. 1 I. �'r". ,+' q' t,�:� v if ,^ •Ir , :rF
i�N r• ,''� .� 1 � ,� +' �,�'�'._•�(' a v':+ , a;,�. .�ir.. a �'1�,18•�•',4�, �'!;
�1 ��r '��r.�1� 'f.�{A,y',�.,,,�+ .;{d� �•�1:' g ,.��1:'R" - ��pj ,i��'t��\�1 ' ��`�, u
�7ylk '� �j�{�'; 7 'j'�jp �?' , �, � .1•"(y ) �y�,�I ��,' 'il fy.� � ,��p�4k,�„a:{J{ o,�• 19J�
l �j ,F��• ? y "Y� r,�4 Y
1�k5�%r<, 'r '' "c+,.ls„"e'hi�'+`-W' '''. ° �`,�p ,• ^, ;"rye �i ',a
•ss>tLii�atx57�tbi>..��Y-, •��.F•�c::r.':W'�,fi"U",yi?ii�.aY::,J�Scx�=:��z�Ya���-'�rI�n�-3":'t'�''
, lk � r'.t t. �,4..% SQ aR R:,t•,h.>r`t .ter,^�
i"Active"Model 91at11S are those that an AHRI Certification Program Pargelpant Is currently producing AND galling or offering for Bale;OR new models that are being
marketed bw are net yet being prddueed,"Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing BUT Is still
�along or orferinp for sale,
atlnae that are acf�RHei9Sl by WA6 Indicate an Involuntary re•rate. The new oublithad rating it Shown along with the previous fi.e.WAS)rating.
DISCLAIMER
AHRI doea net endorse the produags)listed on this Certificate and makes no representations,warranties or guarantees as to,arld assumes no reeponalbiilty for,
the product(a)listed on this Certificate.AHRI expressly dMolalma all liability for damages of any kind arising out of the use or performance of the pioduct(s),of the
unauthorized alteration of date listed on this CertineSte.Certified ratings are valid only for models and configurations listed In the
directory at www.nhridireatoiy.org,
TERMS AND CONDITIONS
This Certificate and its content&are proprietary products of AHRI,Thle Certificate shall only be used for Individual,personal and
confidentlal reference purpose&,The contents of this Certificate may not,In whole or In pert,be reproduced;oopledi dissaminated;
entered lino a computer database,or otherwise utilized,In any form or manner or by any means,except for the user's lnd]Vldual, Aram
personal and confidential reference. AIR-CONDITIONiNG,HEATING,
CERTIFICATE VERIFICATION Q REPMOERATION INSYrf=
The InformoVon for the model cited an thin certificate can be verified at WWW.Ahridledotary.org,click on'Verify Certificate'link we makr life hetrri'-
and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which la listed above,and the Certificate No.,which Is listed at bottom right
02021 Air-Condltiohing,Heating,and Refrigeration Institute NO.: 1328275eg91R.7•
;��,,•�'