Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSDate: Fee Due: 1 Receipt# Permit # Planning &. Development Services A SCANNED Building & Code Regulations Division SCANNED 2300 Virginia Ave. BY Fort Pierce, FL 34982 St. Lucie r. (772)462-1553 COunPy 1 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Addri 2. Parcel ID Number: Township Range Map Page Z ning an Use I ' 'als Of,Sce Use Section Only 3. Complete Description of Project or Work: �� ('i� ���1r C; 'X 4. Owners Information . 5. Contractors Information Name: FL Reg/Cert #: Address: County Cert#: City: _ State: Business Name: Zip: Ct 25 g, Phone: ►� Q g.- p k?:!0gPhone: Fax: 6. Value of Construction: $ :5 . 0-'r5 C) 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 regulating construction and zoning. D.� PRINT OR NTRACTOR AMET SIGNATURE OF OWNER OONTRXC 0� n r STATE OF FLORIDA, COUNTY OF C l P. ACKNOWLEDGED BEFORE ME THIS DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRO: AS ID=IFICATION. SIGNATURE OF NOT 1 COMMISSION NUMBER 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 $7500.00 Revised 04/26/2010 NOTICE TO OWNER: FAILUR .x ') RECORD A NOTICE OF COMMENCEMENT: RESULT IN YOUR PAYING TWICE FOR IlVIPRO`:,.a,4 3NTS TO YOUR PROPERTY. IF YOU INTEItpt `0 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CON SIENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5,000. 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. ❑ teas 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 ❑ RVAC 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. .......... 1610 t ; 14 !1!, em 'f'. t I t in AHRI Certified Reference Number: 5053564 Date: 7/30/2013 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: PAJ348000K**OA2 Manufacturer: ARCOAIRE Trade/Brand name: R41OA AC SPP Manufacturer responsible for the rating of this system combination is ARCOAIRE Rated as follows in accordance with AHRI Standard 2101240-2008 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): 46500 EER Rating (CooliVng): 11.00 :SEER Ratih6�(Cbcling) - 1 ,20 f i g 2 a P h yy A i i r r r K x � P Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the products) 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.ahridirectoryorg. 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, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectoryorg, A "®® Air -Conditioning, Heating, click on 'Verify Ce�caWl link and enter the AHRI Certified Refdrenee Number and the date on tow■� -® and Refrigeration Institute which the certificate was issued, which is fisted above, and the Certificate No., which is listed below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130196687779444700 St. Lucie 6. : tty Building & Zoning (Department 2300 Virginia Avenue Fort Fierce, Florida 34982 (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 (7) EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must provide direct, on -site supervision of the construction yourself. You may build or improve farm outbuildings, a one -family or two-family residence or a commercial building at a cost of under $75;000.00. The building or residence must be, for your own. occupancy. It may not be built or ,substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people- working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not'delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial 5'_ I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial I understand that if I compensate any person or company for work performed they are required to be licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost of the license. Initial S , r� I understand that if any person that is unlicensed and uninsured gets injured on my construction project - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related,medical cost, which could include loss of wages during recovery from their injury. Initial To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further • understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and �T-gdayDepartm t to the Florida State Department of Professional Regulation.. Signed and acknowledged on this of -` of 20 ` Owner/Builder Si tore f STATE OF FLORIDA COUNTY OF The foregoin instrume was acknowled, by lai produced Title: before me this QL day of w o is personally known an identification. Type or Pit Name of Notary Commission ber 20�, ho has ANGELA M. HUFF MY OOMUSSION # EE 083530 80nd EXPIRES; April 12 2015 ed 7 ��Pa61ic Underwriters