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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-30-2016 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 Commercial Residential XX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 8840 CHAMPIONS WAY, PORT ST LUCIE, FL 34986
Legal Description: LAKES AT PGA VILLAGE
Property Tax ID #: 3334-501-0073-000-5
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE AC CHANGEOUT, 5 TON LENNOX, 14.5 SEER, 10 KW
R►HVAC
11 Electric
Plumbing
Sprinklers
Generator
Lot No.
Block No.
Windows/Doors
11 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 5980.00 Utilities:OSewer 0 Septic Building Height:
Roof pitch
OWNERAESSEE:
CONTRACTOR:
NameJAY WOHL
Name: PHILIP NISA JR
Company: NIS AIR AC
Address: 3700 S US HIGHWAY 1
Address: 8840 CHAMPIONS WAY
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
City: FORT PIERCE State: FL
Phone No. 201-960-9556
Zip Code: 34982 Fax:
Phone No. 772-466-8115
E -Mail:
Fill in fee simple Title Holder on next page ( if different
E -Mail: NSIMMONS@NISAIR.COM
from the Owner listed above)
State or County License: CAC041199
if value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
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: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 fist inspection. If you intend to obtain financing, consultwit lender or an attorney before
commencinRlwork or recording your Notice of Commencement.
ctor as Agent for
STATE OkFLORIDI
COUNTY F STLUCIE
The forgoing instrument was cknowledged, before me
this2�I'11i ay of "1 --,-- 20ttiy by
PHILIP NISA JR --
(Name P person a
ature of Notary Public- State of Florida )
Signature of',PontracTor
STATE OF�ORIDA
COUNTY STLUCIE
The forgoing instrument was acknowledged before me
this 30TH day of NOVEMBER 20 K-0by
PHILIP NISA.
(Name of
of Notary Public- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission NO, FF201485 I :�;tiiF kWA; ,SAITSHOL164nmission No. FF201485
++T!'0R ?N!7'r r fbv ,i., ., i I int ?l MY
Revised 07/15/2014 I+4orissisoaa3 Fr.00"`
EWTSHOLTS
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
.1 010411 111, 1
AHRI Certified Reference Number: 5732792 Date: 11/30/2016
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 14ACX-059-230-04
Indoor Unit Model Number: CBX25UH-060-230=
Manufacturer: LENNOX INDUSTRIES, INC.
Trade/Brand name: MERIT
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME,
MI, 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: 14ACX SERIES
Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC.
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): 56500
EER Rating (Cooling): 12.00
SEER Rating (Cooling): 14.50
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.ahrid!reotory.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 individual,
personal and confidential reference. AIR-CONDITIONING, HATING,
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.: 131249879305690598