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HomeMy WebLinkAboutczerniejewski.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -2;'t (5- IZ2 Permit Number: V,, LCUL r aia:. 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: '"' PROPOSED IMPROVEMENT LOCATION: + y „„af r Address: l a Y)o aec' _ \ -] 0 X Property Tax ID #: L] S 1 - 17) "i- 00 S i�OC� -- C f Lot No. Site Plan Name: 3�ck �j � ci CZ-e_rn ,1'_ e vJS , Block No. Project Name: Fes) wn"'5 Ac se_"-,C-es . ! , New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Addittiional work to be performed under this permit - check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Generator Sq. Ft. of First Floor: Windows/Doors _ Pond Roof Pitch Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height: Name �_ ,— C 7 C'if\ . e \ A, Address: 1DOD0 S City: 7.p)D5� X�\ 2?ios� State: F Zip Code: 2)A01 S-71' Fax: Phone No. ' (p1" _15CS - a0�2 E- Mail Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Company: Address: i 2,'A -S It YVN0.1 G.s% Cityl-rpn ,yy\ C.%1 A State: Zip Code: E�4 C1 610 Fax: -n a 1 1130 } Phone No Z1 -J., - ag l -- Ll I It-( E-Mail F n". Corn GlS b 2 State or County I icen e 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. i - ,= e — Uy I I Iduto omain 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 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 grantin of th' in accordance with the a g Is requested permit, I do hereby agree that I will, in all respects, perform the work pproved 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 lender or an attorney before commencing work or recording our Notice of Commencement. Signo6re of Ow r/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of this 1S daY _ofAA0.rLA1 20—7-?-by Physical Presence or Online Notarization Name of personmliking— 'state Personally Known OR Produced Identification Type of Idication r duced blic- State of Florida ) Commission No. / +tfl I ZW114 (Seal) SOWN Notary Public State of Florida Samantha L Jones My Commission HH 124114 h Expires 0512512025 REVIEWS FRONT ZONING COUNTER REVIEW SUPERVISOR PLANS VEGETATION DATE REVIEW REVIEW REVIEW RECEIVED DATE COMPLETED SEA TURTLE I MANGROVE REVIEW REVIEW AHRI Certified Reference Number: 8641232 Date : 03-15-2022 Model Status : Active AHRI Type: SCP-RCU-A-CB (Space Constrained Air Conditioner, Condensing Unit, Coil and Blower, Air Cooled) Outdoor Unit Brand Name: NATIONAL Outdoor Unit Model Number (Condenser or Single Package) : NCPE-430-3010 Indoor Unit Model Number (Evaporator and/or Air Handler) : NCPAH-36-Al 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 NATIONAL 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 party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 27200 SEER: 12.00 EER (A2) - Single or High Stage (95F) : 10.50 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 prod uced."Production Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied by WAS indicate an involuntary re -rate. The new published rating is shown alona with the previous (i.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.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, AM personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridlrectory.org, click on "Verify Certificate" link the 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. ©2022Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 132918460997394843