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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 /11 /2022 Permit Number: Date: 27o K,o v _ Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Plerce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Cl3DG Funding PERMIT APPLICATION FOR PJOQSED 11b1P_ROU[yIENTL CO AT ON.- `_ on a Address: 11295 MULLER ROAD PropertyTax lD f: 2333-422-0000-000-5 Lot No. Site Plan Name: Block No, Project Name: HARVEN TAMARA CROUSE LIKE FOR LIKE AC CHANGE OUT 3 TON 10 KW 16 SEER New Electrical Meter Second Electrical Meter. (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: $ 9,393.00 Utilities: _Sewer _ Septic Building Height: GTNTR/�CT©Tt OG�hN LESSEE h. �pg ig _ Christopher Lanclel Name HARVEN TAMARA CROUSE Name: Address: 11295 MULL FR ROAD Company:c r nir c r A4atal Inr FT PIERCE State: FL Address: 3108 INDUSTRIAL 31ST STREET City: Zip Code: 34945 Fax: City: FT PIERCE State: FL 772-466-1027 E- Zip Code: 34946 Fax: 772-448-4416 Phone No. Mail: Phone No 772-466-2400 Fill in fee simple Title Holder on next page (if different E-Mail INFO(@,SEACOASTAIR.COM from the Owner listed above) State or County License CMC0.35421 If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required. If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required, �SUsPPI��Ml;,1�TF';I GdN$TR�TCTtONr�IEN LfAW:1N'F��R��4'P[OfV DESIGNER/ENGINEER: _Not Applicable Name: MORTGAGE COMPANY: _Not Applicable Name: _ Address: Address: City: Zip: Phone: Stater City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: Name: Not Applicable 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 snakesyno representation that is granting a permit will authorize the permit holder to build the subject structure structure. phrase consultawithyour Homeowners Association anldrebylaws our deed fort any restrictions which or prohibit such 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 t. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult k^r,,.o P ,nrk nr rprnrriinp vnur Notice of Commencement, e ` (�— signature of Contractor- or - Owner Builder as applicable STATE OF FLORIDA COUNTY OF ST LUCIE Sworn to (or affirs�r�r dbscrlbed before me of ' X Physical Presence or. Online Notarization this 11 day of 20 22 by CHRISTOPHER LANGEL Name of person making statement. Personally Known _X OR Produced Identification Type of Identification Produced ( nU og�OA ( nature of Notary Public- State of Florida) 'tin:°�`•• JUSTINAL, HOPKINS CONNELLY Commission No. A °`p'. „C��call i._ MY COMMISSION# GO940662 Syt,,r.; EXPIRES: Decembar 17, 2023 OPP" 1'1' Bonded Thru Notary Public UndeWter¢ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 1u/12jt3 Eligible for Federal Tax Credit • • • ;• • 10 �' AHRI Certified Reference Number: 20'1304313 Date : 01-11-2022 Model Status :Active Old AHRI Reference Number: 8242079 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: GSX16 Outdoor Unit Brand Name: GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GSX160361 F" Indoor Unit Model Number (Evaporator and/or Air Handler) : ASPT47D14A' Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, Ri, SC, SO, 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 13 2016 central air conditioners can only be installed in regions) for t"Active" Model Status are those that an AHRI Cediflcation 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 Certifcatlon Program Participant is no longer producing BUT Is still Iling or offering for sale. R t a th t a p led by WAS Indicate n involuntaw re-rate.re-rate. The published retire' h wn alone 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 products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the products), 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 arm 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, AIR-CONDITIONING, HEATING, personal and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information fertile model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life bearer' 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 132863968096930346 ©2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: