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Home My WebLink AboutSUBMITTED PAPERSDate: Fee Due: "4o Receipt# '1`M%D _-:rmit # I ` 4)G -40; Planning & Development Services w �i11 Building &Code Regulations Division 2300 Virginia Ave. S'C/I Fort Pierce, FL 34982 �/lll� (772)462-1553 Fax 462-1578?` �(/10iBi" SPECIALTY PERMIT APPLICATION CO ❑ Electrical ❑ Plumbing HVAC ❑ Fence ❑ Shed* [I Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 2. Parcel ID Number: 3402- —(GO r02 32 —000' � 3. Complete Description of Project or Work: /W L7C2— � %�/J �ccx—/ 4. Owners Information 5. Contractors Information Name: t�)q ydolJ-O 1 t �,/ 0"1Jl<<%s FL Reg/Cert #: Address: 5 7b `AIUP<�e DR • County Cert#: City: &Ac t Zip: ✓V- Z CAC I gl 7 Z--7$4 State: Business Name: �ict✓f tC /�J/LiL�Z�; ��aLlst-,L(,L Phone: ��Z �Z�`C ()p"4hone:717-334-'M-1 Fax: 6. Value of Construction: $ �Jrbq`0o OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in compliance with all applicable laws r ating construction and zoning. PRINT OWNER OR CONTRACTOR NAME SIGN TURF OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF L V 6 ` ACKNOWLEDGED BEFORE ME THIS DAY OF t% M 20 `A BY Q Y`>\� S .c X.11� J\ WHO IS PERSONALLY KNOWN TO ME O IO HAS PRODUCED 4Aes 4 5 •"" DEANNA GIVENS �•• RV P B IDENTIFICATION. �'r°.�.`� Notary Public -State of Florida ' : •_ My Comm. Expires D�c 16, 2016 4� •� �C Commission 858761 SIGNATURE OF NOTAR TYPE OR PRINT NAME OF NOT Y -:�oF F �q:�` Bonded Through National Notary Assn. COMMISSIONNUMEER��1 CD l *ALL RESIDENTIAL AND NONRESIDENTIAL STRUCTURES ARE REQURIED TO MEET THE FLOOD ZONE ELEVATION OR 18 INCHES ABOVE THE CROWN OF THE ROAD, WHICHEVER IS APPLICABLE. (see instructions on reverse side of this sheet) Revised 04/17/2014 f ` NOTICE'TO OWNER:. FAILU)2.-- ,!TO RECORD A NOTICE OF COMMENCEMEN"-....AY '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 $7,500.00 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 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 describes 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. 6. Value of Construction 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 ❑ ,;; :-_�� No attachments necessary 0 "" Ct'a :1!!7i!si •Ciriil -. h This applications 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. Upon issuance of this permit, required inspections can be scheduled by calling 1-866-284-1280 or logging on to http://codeinspectionpublic.stlucieco.gov/ This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. Certificate of Product Ratings AHRI Certified Reference Number: 5884597 Date: 5/30/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TT136036A1 Indoor Unit Model Number: *AM7AOC36H31 Manufacturer: TRANE Trade/Brand name: XB16 Series name: Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing:. Cooling Capacity.(Btuh): 35600 t EE--Rafing: (Cooling) 13 00 1, 1, SEER Rating -(Cooling): `•..v- . 1600 IEER'Rating (Cooling): ,.`1f r 4 � i did � r rh �,.' i 1 s� ` 0; j y '. i.i U) b ., Ratings followed by an asterisk C) Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. 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) fisted 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.ahrldlrectory.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; SOW Ewa 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 cordidential 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 i e 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 1304593Q5486285C ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO::