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Home My WebLink Aboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Mechanical PROPOSED INPROVEMENT LOCATION: Address Legal Des Commercial Residential Property Tax ID #: ? ��j •- 1a' — Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional worK toe er orme under this permit – c ec a t1h app y: ✓HVAC El Gas Tank ❑Gas Piping Shutters Electric Plumbing Sprinklers Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ --j `I C�t—" Ca Utilities: []Sewer E- Septic Block No. Windows/Doors Roof Building Height: OWNER/LESSEE: CONTRACTOR: CENTURY AIR COND Name- Y / It Ujry ',,L_1 LtA Lk _ tLt I u Address: �` ., 311 i City �- " k4-( State: FL Zip Code: G�� Fax: Phone No. E -Mail: (;r , f Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: JOHN RILEY Company: CENTURY AIR COND Address: 3044 SE DOMINICA TERR City: STUART Zip Code: 34997 Fax: _ Phone No. 772-781-3040 E -Mail: centuryac@aol.com State or County License: CAC057676 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. State. FL � COUNTY L O R I D Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Mechanical PROPOSED INPROVEMENT LOCATION: Address Legal Des Commercial Residential Property Tax ID #: ? ��j •- 1a' — Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional worK toe er orme under this permit – c ec a t1h app y: ✓HVAC El Gas Tank ❑Gas Piping Shutters Electric Plumbing Sprinklers Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ --j `I C�t—" Ca Utilities: []Sewer E- Septic Block No. Windows/Doors Roof Building Height: OWNER/LESSEE: CONTRACTOR: CENTURY AIR COND Name- Y / It Ujry ',,L_1 LtA Lk _ tLt I u Address: �` ., 311 i City �- " k4-( State: FL Zip Code: G�� Fax: Phone No. E -Mail: (;r , f Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: JOHN RILEY Company: CENTURY AIR COND Address: 3044 SE DOMINICA TERR City: STUART Zip Code: 34997 Fax: _ Phone No. 772-781-3040 E -Mail: centuryac@aol.com State or County License: CAC057676 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. State. FL SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not Name: i Address: Address: City: City: Zip: Phone: 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 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 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before comr-0encing work or recording our Notice of Commencement. LL SigV6 ure f Owner/ gent/ Lessee Signa re f ontract6r/License Holder ST'A E OF FLORIDA STATE OF FLORIDA_ COUNTY OF �- I COUNTY oL��c� OF The forgoing instrument was acknowledged before me The forgo?Jng instrument was acknowledged before me this ay of 20L_J by thi r_Aday of -_ � 20[Dby I ICA (Name of person acknowl (Name of person ackno gr (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. SHAVY" uSSELL Commission No. , g A RUSSELL ••' y !Wary Public • State of Florida �,� Notary Public • State of Florida FIF 958939s• .. , My Comm. Expires Mar 11, 2020 y Revised 07/1- ti '; r� My Comm. Expires Mar 11. 202, National Notary Assn •,, �. Bonded through Bonded through National Not ary a, , REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 8784478 Date: 7/21/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4A7A6024J1 Manufacturer: AMERICAN STANDARD Indoor Unit Model Number: TMM5AOB24M21SAA Manufacturer: AMERICAN STANDARD Trade/Brand name: AMERICAN STANDARD Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, M1, 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. Series name: Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD 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): 24000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): 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 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 i 04 "12' 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; ■. `'personal 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 vww.ahrid lrectory.org, dick on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued. we make life better' which is listed above, and the Certificate No., which is listed at bottom right @2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131136204397834447 - BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE • FORT PIERCE, FL 34982 • 772-462-1553 .- FAX 772-462-1578 AUTHORIZATION FORM FOR CREDIT CARD PAYMENT T0: St Lucie County Permit # Credit Card Users: 1.5010 Surcharge added per transaction. Payments must be received in this department by 4:00 PM for transaction to be processed that day, if not it will be processed the following business day. VISA MASTERCARD Credit Card Number D -2 4- a Expiration Date Zip Code 514993 3 digit security code -7o-,5 Amount $ Raj , oD + 1.5% surcharge Business Name: Authorized Signal Print Name: .a�a-i - -, - - *7::,-" S-<. eJ Phone: (7a- -) - SCS 8' Fax: (-1-i ) 344 - Le4 Comments: SLCPDSD Revised 4/01/2010 EN