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HomeMy WebLinkAboutSUBMITTED PAPERSPlanning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing C? HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 18705 MACH ONE DR 2. ParceI ID Number: 3215-801-0020-000-4 S� �4�i� YNFO �00, off ce ave Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: LIKE FOR LIKE A/C CHANGEOUT INSTALL 1.5 TON 16 SEER GOODMAN SPLIT SYSTEM 5KW HEAT HORIZONTAL APPLICATION 0 f 4. Owners Information Name: / V M APO u) 5. Contractors Information FL Reg/Cert #: Address: &72C Ael E bA County Cert#: 27009 City: FT PIERCE State: FL Business Name: RHARKPY AIR, LI C Zip: 34987 Phone: 772-260-1039 Phone:_772-220-2487 Fax: 772-220-3787 6. Value of Construction: $ 2893.00 OWNERS AFFIDAVIT: I certify that all of the information contained in this application compliance With all applicable laws regulatil� c�truction and KEl/IN M SHARKF=y " L. PRINT OWNER OR CONTRACTOR NAME'SIGNATURE OF OWNER OR STATE OF FLORIDA, COUNTY OF MARTIN ACKNOWLEDGED BEFOREMETHIS 21_ST DAYOF QrTQRFR ,20--14_,BY KF1lIN M_ SHARKFY WHO IS PE)ISONALLY KNOWN TOME -/ OR WHO HAS PRODUCED TYPE OR PRINT NAME OF NOTARY NUMBER EE179960 be done in KATE MADELINE WIEGERINK MY(gWMISSION # EE179960 EXPIRES April 14, 2016 NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7soo oo Revised 04126/2010 NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5,OW. INSTRUCTIONS Please complete all information in the space provided. All .information must be printed (use black or blue ink only) or typed. This permit application is to be used only for those activities that are not otherwise included under a primary building permit. This application may not be used for any activity that includes structural alteration. The information to be provided with this application includes: 1. Location/Site Address 2. Parcel ID Number 3. Description of Project or Work Activity 4. Owner Information 5. Contractor Information 6. Value of Construction Indicate the street address or general location of property where the building activity is taking place. Indicate the tax identification number of the property where the building activity is taking place. Fully describe the activity to take place. Indicate the name and address of the owner of the property on which activity is taking place. Indicate the State of Florida registration number (if applicable), St. Lucie County contractor license number and the name of the business doing the work. Indicate the total value of the work to take place. Total cost of construction includes all current retail material and labor costs associated with the building/construction activity. Construction value is used to determine the permit fee. St. Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction. ❑ Gas Attach 2 piping schematics with tank size,location, and BTU of each appliance ❑ Shed: Attach 2 plot plans, 2 copies of DCA letter and plans, 2 anchor specifications ❑ Fence Attach 2 plot plans showing location of fence height of fence and type of fence ❑ Siding Attach 2 copies of manufactures specifications G?HVAC Attach 2 residential energy studies, 2 manual J calculations. 2 sets of duct layouts for new system or full replacement This application can be submitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. All permit applications must be filled out completely before submission. No applications will be accepted for processing after 4:30 P.M. For assistance in completing this application, please call (772) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. NOTE. Emergency electric service change out inspections will not be performed after 3: 00 PM without special arrangements and additional fee paid. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261. This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. AHRI Certified Reference Number: 5756171 Date: 10/21/2014 CEE Tier: CEE Tier 2 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX160181F* Indoor Unit Model Number: ASPT24B14A* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR CONDITIONING AND HEATING; ENERGI AIR Series name: GSX16 Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. a - He pal * Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. urce ird DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responslbillty 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 AHRI. This Certificate shall only be used for individual, personal and AM 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, 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.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. ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE ..... NO 130583923854114� This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. AHRI Certified Reference Number: 5756171 Date: 10/21/2014 CEE Tier: CEE Tier 2 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX160181F* Indoor Unit Model Number: ASPT24B14A* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR CONDITIONING AND HEATING; ENERGI AIR Series name: GSX16 Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. Ra He pa Ratings followed by an asterisk(*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. urce ird 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 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 Indivldual, 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.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. i ,' -' " - _ ©2014 Air -Conditioning, Heating,,,and Refrigeration Institute