HomeMy WebLinkAboutPermit App - 8495 Juneberry Ct - SLC.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: LPL
PROPOSED IMPROVEMENT LOCATION:
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Address: 'r�-`��`. r, J ��i�C! f7 ��_
Property Tax ID #: Lot No.
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Site Plan Name: 4 ' 1 _ _ Block No. Ql�b?
Project Name:,�'�>
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
C�
Cost of Construction: $ b I Utilities: Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ,� �(Zr
Name:��Cty�`��
Company:'( Cc -- LL.0
Address: F-1� 3�C tLr7_O-C CA
City: L✓ Stater
Address: u-1
Zip Code: 2�5pll Fax:
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City: Stater
Phone No. �C5N E-
Zip Code: 3t-(�Sa Fax: 'l a - - �
Mail:
Phone No.- -
Fill in fee simple Title Holder on next page (if different
E-Mail c'CM fit W.'Z l . C A' cxn
from the Owner listed above)
State or County License cx,�e 1 r9n Sao
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
State:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name: _
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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult 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.
kLucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
ith lender QLaaattornev before commencing work or recordine vour Notice of Commpnr.PmPnt.
Signature of Contra r - or - Owner Builder as applicable
STATE OF FLO&ADA
COUNTY OF l
5wor `t (pr affirm_ dj and subscribed before me of Physical Presence or Online Notarization
this day
of 2QDby
Name of person making statement.
Personally Known \0 OR Produced Identification
Type Produced
lofentifjcation
JCA_,
(Signature of Notary Publi State of Fi97,LESLIE
R. ZELAYA
Notary Public
- State of Florida
Commission No. (Seal)� Commission # HH 002558
My Comm. Expires Au; 6, 2024
nded through )eit+Oral Notary Assn.
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Certificate of Product Ratings
AHRI Certified Reference Number : 203381792 Date 02-03-2022 Model Status : Active
AHRI Type: RCUY-A-CB (Year -Round Air -Conditioner, Remote Air -Cooled Condensing Unit)
Series : GSX16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX16S421A*
Indoor Unit Model Number (Evaporator and/or Air Handler) : CA`F4860'6D"
Furnace Model Number GMES800805C"A"
Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS. NC, OK, SC, TN, TX, VA, 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 instalied in region(s) for
which they meet the regional efficiency requirement.
The manufacturer of this GOODMAN product is responsible for the rating of this system combination,
Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third parry testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 40000
SEER : 14.5D
EER (A2) - Single or High Stage (95F) . 12.20
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.
Rat, ngs that are accompanied by WAS indicate an involuntary re -rate. The new oublained rating is shown along with the previous tl.e. WAS) ratina.
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 Al 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 individua
l.
personal and confidential reference, AIR CONDITIONING. HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTRUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we 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. —
02022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1328837WO1723726