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All APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' () rh %1 Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort- Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: NMtV ay�l PROPOSED IMPROVEMENT LOCATION: Address; I b I?A" t 1I Property Tax ID #: ��� 1 1- S� 0061 -� Site Plan Name: Project Name: WU /q C %141 t DETAILED DESCRIPTION OF WORK: k New Electrical Meter __ Second Electrical Meter UUNS I RUCTION 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 R f Total Sq. Ft of Construction. Cost of Construction: $ 141 40, aQ 0o Pitch Sq.tFt. of First Floor: Utilities: —Sewer —Septic OWNER/LESSEE: CONTRACTOR. Name V �^' Name: U . Address: ® Company: �•( City: ii�� State: Address:111 Zip Code: `1 Fax: City: f1 ucl Phone No. Zip Code: MMI E-Mail: Y Phone No_� Fill in fee simple Title older on next page ( if different E-Mail l from the Owner listed above] State Of Coun1v 1 iCPnco 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. Building Height: T Fax:11%. �li IA — Y SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Nat ApplicableTORTGAGE COMPANY: Not Applicable Address: ame:City: ddress: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ N©t Applicable BONDING COMPANY: _Not Applicable Name: Address: Name: City: Address: Zip: Phone: 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 noy!work or installation has commenced prior to the issuance of a permit. no which is noconflicmtawith anrepresentation pplicabletHome aOwners Association'rules,abylaws or andpcovenantss that buildthe or prop bitsuch 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 y operty. A Notice of Commencement must be recorded in the public records of St. Lucie Coun osted the jobsite before the first inspection. If you intend to obtain financing, consult with lend r o n at me efore Commencing work or recording our Notice of Commencement. Signature of Oder/ r as Agent for Owner STATE OF FLORIDA c, COUNTY OF M . Sworn to (or affirm d) nd subscribed befo e me of this da-y of t f1�i Atli e q'l' -- Physical Presence or Name f-gerk(�n making statement. by V OR Produced Identification �roduced Com (�{�j� //�� 'on fV__g,,��11 (Seal) otPRY PUa� MARLENE LILT CbLLAU® Commission # GG 171582 N - Expires April 25, 2022 9T�Orrvl� 9ondedThruBudget Notary services REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION COUNTER REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED - - — ev Online Notarization SEA TURTLE I MANGROVE REVIEW REVIEW Unico Air Conditioning Company 1711 Sunset Isle Rd Ft Pierce, A 34949 Phone: (772) 678-6676 Fax: (772)647-7525 Billing Address Unico Air Conditioning Company 1711 Sunset Isle Rd Ft Pierce,Fl 34949 Shipping Address: Terms of payment: Term of delivery: Equipment ready for up at HD Supply Contract Document Number 51007510350 1/4/2022 Caroline Johnson Pine Lakes Preserve 7389 Pine Lakes Blvd Apt 7389 Port St Lucie 772-245-4530 Net 15 Days ZOR(FOB Origin) (tern Material/Description Quantity Unit Price Amount 1 Install Indoor/Outdoor AC Unit 1 $2,200.00 $2,200.00 Int. Article No. 25937855 2 Ton Tempstar 14 SEER Subtotal: $2,200.00 Tax: $ Signature: ETotal: Gra$2,20 . i CERTIFIEDCertificate of Product Ratin WY.'vY.i3ilrtdlreCtOly.Cftl AHRi Certified Reference Number ; 201852667 Date :11-13-2018 AHRI Type: RGU-A-CB Series: 14 SEER N SERIES R410A AC Outdoor Unit Brand Name: TEMPSTAR Outdoor Unit Model Number (Condenser or Single Package) : NXA424(A,G)KG** Indoor Unit Model Number (Evaporator and/or Air Handler) . FMA4P24**AL* Model Status: Active Region : North (AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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 TEMPSTAR product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air -Conditioning 8, 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 : 22800 &, dw s i 19 11 r IN iM M SEER - 14.00 EER (A2) - Single or High Stage (95 f"Active" but are not yet Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale: OR now modals that arm hoins eallingtoOffering for sale.f rig prOdUCed,'P(OtlUCGOn Stopped" Model Status are those that an AHRI Certification PrOgram Participant Is no longer producing BUT is still Patinas that are gcco anied byyVAS ndisatee an invelun r ,-r ts. The new published rating is hown along vaith the nfeviD_ u� s (fie _WAS) ratme DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes noponsibility 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 threse 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 wwrv.ahridlrectory,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, oil personal and confidontial raforon— CERTIFICATE VERIFICATION avz cotiomekw� _ Hit. 4_ Tho information for the moues Cited On this certificate can be Verified at www.ahrldhecfory.org, click on `Verify Certificate" link f[EMUERATION INSTITUTE and enter the AHRI Certified Reference Number and the date on which the certificate was issued, the make life better"' which is listed above, and the Certificate No., which is listed at bottom right. r--------- ©2018Air-Conditioning, Heating, and Refrigeration Institute I CERT11=1rAT1= KIn • 1318662110863162522