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HomeMy WebLinkAboutPERMIT APPLICATION S:
All APPLICABLE INVO MUST BE:COMPLETED F6R APPi iCATifSN T E ACCERT6D �
Date: Permit Number: �V1.V 0.11 S
E
-' - Building Permit Application
planning and Development Services
Building and Code Regulation DN/Slan
2300 Virginia Avenue Fort pierce FL 34982
Phone:(772)462-15$3 Fax:(772)-462,-1578 CQITI:I1'lercial Resi:dential'
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PERMIT APPLICATION FOR:
P P• ED NPME T Ott.
Address: 56 10 P(�ei-Yee O
Legal Description. I ViC�i WR 1,NuQ e SEct ke.S
I. .
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Property Tax ID#: 3402- 6 Off- - 02 98 - 000 -.3 Lot No. Z\.
Site Plan Name: Block No.
t. ProjectNam.e:.
Setbacks front Back:... ._. Right Side Left Side:. ..
DETa! ED D 'C iP C}N C•}F 11 • R
f: -)(_ A rt r,,Lced
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0d.itionalwor :to bepertormedun,.er t:is permit:=check all that app y:
4. Amecha.nical Gas Tank _.Gas.P ping Shwtters' .? Windows/Do.ors
Electric Plumbing _Sprinklers Generator Roof
Total.Sq. Ftof-Construction:_ 13� �- q.
5 Ft.of First Floor:.
r Cost:of Construction:S .71S ? - 4 o Utilities: _Sewer _Septic: Building Height:
Name H(� yl (Z1:3 UPASOVI _ . Name; w1-I'U Ai e� C(9fAC)144r)V1 .a CP
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i1 Address: S A t c3 t' C.✓LP V e �1(" Company: ry _1ek+ 1"1_eA1.
City: . p�r t.
P.i e'Ce-. State: L Address: 5-71. MW P& un w4e.
Zip Code:34 0182 Fax: City: I,Gf/f 9{ L1J[i�C' Staten�L
Phone No. 77-L �A 6 1 ( 70 L. ;dip Code. 6 Fax:
E-Mail:. Phone No. 7.7 2- 00 - PSG Q
t Fillin fee simple title Holder on next page(if different E.-Mail:0 f1j]2{,C!�`1
from the Ownerlisted above) State or County.License. _( d�G I (6l.��t..
E: If value of consEruction is 2$00 or more,a RECORDEb Notice of Commencement is:required:
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F _
i DESLGNER/ENGINEER: _:Nof Applicable MORTGAGE COMPANY: _Nat:Applicable
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Name: Name:
Address Address:
i. City: State: City: State.,.
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Zi Phone: tip Phone:
P=.
FEE SIMPLE.TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
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Name;
I'. Address: Address
City: Cit
.. y:
Zip:. Phone: Zlp . Phone
OWNER/CONTRACTORAFFIDVIT:Application is hereby made to obtain a:permit.to do the work and installation as indicated:
1 I certify that no work.or installationhascornmenced.prior to°the.issuance of a permit:
I St..Lucie County makes:no.representation that is.granting a:perrriit will authorize the permit.holder to build the subiectstructure
which is in conflict with,any.applicable Home. Association rules,bylaws or andcovenantsthat may restrict or prohibit such:
structure.Please consult with your Home-Owners Association and review your deed for anyrestcictions.which may apply.
in:consideration of the granting of:this requested permit;i do hei ety agree that f 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 appllcations:are exempt from undergoing a full concurrency review:;room additions,.
E. accessorystructures;:swimming.poois,fences,walls,signs, creeh.to*om's and.accessoryuses to another°non-residentialuse
WARNING TO OWNER'.Your failure:to_Record a.Notice.of Commencement may result in.yourpaying 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 attorneybefore..
commencing work or recordin o r Notice of Commencement.
I I
I.
Signature Owner/'Age.nt/Lessee Signature of Co or/License Holder
i STATE OF.FLORID�j.�, STATE OF FLORIDA
COUNTY OF5—
1 f 0
COUNTY OF Lu L',�'� �
L'.
Th.tf.rgoing:instrument was>acknowledged before.me The f_ofgomg instru nt was acknowledged before me
this day of 201 Eby this m day of e,�,20 (e by
0-
(Na, e of person ac nowledging:,) (Name of pegs ncknowledging).
(Signature of Notary.Pub` -state-of Florida) (signature of Notary Public-StiteofFlorida
Personally.Known OR.Produced Identification
Personally,Known 1 _ORProduced.identifcation, Y. _
Type of identifies ' Type of Identficatio17100
vPW ; DEBORAH RUSSELL =� 4¢ DEBORAH RUSSELL
Co.mrnission No.4 :+ �? Notary Pu&agtate of Florida Commission No. - Notary P�(6�I�al}tate of Florida
y Cam Expires,
-
= = Commission#FF 179630 ?y ' Commission N FF 179630
",', P ov 30.2018 '%'Favi M
is
'anuna .
REVIEWS. )N SUPERVISOR PLANS VEGETATION SEA. R L E
` mq
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
i. _
is
DATE
RECEIVED _.,.
DATE
l COMPLETED'
t -Re—v..71.2014
F
1
e 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: 7626354 Date: 9/8/2016
Product:Split System:Air-Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 14ACXS036-230A**
Indoor Unit Model Number:CBX27UH-036-230*+TDR
Manufacturer: LENNOX INDUSTRIES, INC.
Trade/Brand name: MERIT
Region: Southeast and North(AL,AR, DC, DE, FL, GA, HI, KY, LA, MD,MS, NC, OK, SC,TN,TX,VA
AK,.CO,.CT,ID,_IL,IA,IN, KS,,MA,ME,Ml,-MN,MO,MT,NR,NE,NH,_NJ,
NY, OH,OR, PA, RI, SD, UT,VT,WA,WV,Wl,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
Serres name 14ACX,SERIES
LF fx
Manufacturer responsible for the rattng,dir phis system combination is LENNOX INDUSTRIES,,INC
Rated as follows m accordancewith AHRI'Standartl 210/240 2008 for unitary AIr-Conditlonmg and Air{Sotarce
Heat�Purrlp.Equipment and subject to verification of rafing accuracy by AHRI-sponsored, independent,third
P arty tesfing t �
¢ r
r�
Cooling Capacity(Btuh) 34200
¢h1R-id-14
EER Rating�(Cooling) t 3 c , s s� r
1 Ol}x
SEER Rating(Cooling) 16 00
EER`Rating`(Cooling).
FootNote 12-This air handler is equipped with an Electronically Commutated Motor(ECM)
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.ahrldirectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and A
;
confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated;
'A3
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
L
131178183205085917'„�©2014 Air-Conditioning, Heating,and Refrigeration InstituteRTIFICATE NO