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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE NFO M' ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - �6 Permit Number: i .. _� 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 x PERMIT APPLICATION FOh PROPOSED IMPROVEMENT LOCATION: Addressun Legal Description: 1>0 as r -.q C-0— ccs c`/M/UI; L ok-ir— 1361 - / 65'z Property Tax ID #: 2Lot No.?--�0�� Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTII ON OF WORK: Exact change out of.JqC 3Kzoo D4UVJ 01'*'J�instalied Block No. C'4!z X(EP— 3 .ro n)- 16 s�ir-2 - !D k Lj aK4CCG3(�A4-03z5 "P Vq CA) (Q, i= ) C)DsL_ CONSTRUCTION INFORMATION: AdU—itiona wor to e e Dime un er t �s permit — c1 11c a11"ShuttersWindows/Doors a pP Y� HVAC Gas Tank Gas Piping Electric 0 Plumbing Sprinklers 1 Generator Roof Total Sq. Ft of Construction: S. Ft. of First Floor: Cost of Construction: $ c� CJ�i Utilities:11Sewer 0Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name v-1- S Address: � l eh ltl�L 1 `Z'72fQ C� City: J�r�— , S'T- L14CI a State: PL Zip Code: D Fax: N/A Phone No. ' ] '7 D 3 6S3 E -Mail: N/A Fill in fee simple Title Holder on next page ( If different from the Owner listed above) If value of construction is Name: Zacek. Dennis Company: American Residential Services Address: 2800 US Hwy 1 City: Vero Beach FL State: Zip Code: 32960 Fax: 772 794-9783 Phone No. 772 794-7221 E -Mail: bderby@ars.com State or County License: IC oW 27tR or more, a RECORDED Notice of Commencement is required. SUPPLNENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: x Not Applicable Name: I MORTGAGE COMPANY: x Not Applicabl Address: City: State: Zip: Phone: FEES IMPLE TITLE HOLDER: x Not Applicable Name: Name: e Address: City: State: Zip: _� Phone: BONDING COMPANY: Address: Name: City: Zip: Phone: Address: City: ZIP: . Phone: x Not Applicable I certify that no work or installation has commenced prior to the issuance of a permit. St. Is in Countmakes any applicablelHome Owners tAssociationf rules abylaws or and covenants tha build drestrict o1rr 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 Commencin work or recordin our Notice of Commencement. 1 Signature of O er/ Lessee/Agent STATE OF FLORIDA COUNTY OF smw, The forgoing instru nt wa acknowledged before me this � day of 20 )4by rN •s Signature of Contra r/License Holder STATE OF FLORIDA COUNTY OF Sttude The forgoing instru ent was acknowledged before me this may of 20 1_� by Dennis Zacek (Name of rson acknowledgin J {Name (Signature of Notary Public -State of Fion a J (Sie a Personally Known x OR Produced Identification Type of Identification Produced fr<Ia�?y 9I Commission No. "s2MO (STAIQMAS H- DABEW ��, NOTARY PUBLIC Revised 07/15/2014 w FF128494 Expires 602048 Dennis Zacek Notary Publlc- State Personally Known x OR Produced identification Type of Identification Produced =ft* H DABERKO T Y PUBLIC ATE OF FLOi21DA m FF128494 xv:res E/ 1—IC)IS REVIEWS FRONTZONING SUPERVISOR PLANS COUNTER REVIEW REVIEW REVIEW wTr INITIALS VEGETATION I SEA TURTLE MANGROVE REVIEW REVIEW I REVIEW This combination qualifies for a Federal Energy AMOILICERTIF Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 9179207 Date: 4/26/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 24ACC636A*030* Indoor Unit Model Number: FV4CN(B,F)005L Manufacturer: CARRIER AIR CONDITIONING TradelBrand name: CARRIER AIR CONDITIONING 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, Mi, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, 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: PERFORMANCE 16 AC Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING 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 (13tuh): 34200 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16,00 IEER Rating (Cooling); Ratings followed by an asterisk (ry indicate a voluntary rorate 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 This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used far individual, personal and confidential reference purposes. The contents of this Certificate may not. In whole or In part, be reproduced; coped; dlsseminated; 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 INS'TIMITE The Information for the model cited on this certificate can be verified at www.ahrldirectory.org. click on *Verify Certificate' link me 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. 131376908910779843 ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 911e Addnas I':rrrcl ID Amium k Map IV Use Type: Zonmj; CftyrCounry Ownership Pa -1. kdwt. Paints amsru bub Oleander AVF Farr Pierce. rL 3498: Legal Description POD 25 AT THL RLSLRV L LOT Sb i OR :30:-W'1 Current Values 3usAlarkel Value - Assessed Valuc- Excinpoons Taxable Value T'axat for this parcel SLC Tao Cut cctur'.O; free Q Download TRIM fur this parcel Dw Fl.d PDF 12 Total Areas FmishedlUnder A. '.SFI Grim Arca (SF) Land Sur lacrea?, Land SueiSF) Michelle Franklin, CFA— Saint Lucie County Property Appraiser—All rights reserved. 539-16m) sm.6rm so s1Rz6W 2.990 3,712 1131 13,7119 Property Identification 820r KIAWAII TRACT 31I 703.1x#7 t.RFs U8310 3Y33N 0100 PVD S-A LWK curdy This mfumratKm is believed to be correct m This rant but it is sublarl w dwgc and D not warranted C Copyright 2017 Samt Lucre Cuunry Prupary Appraise- AU rights reserved. ESCUE ARS. ROOTER. Est. Start Date" Installation Work Osier Est. Completion Date , (772) 567-3100 Corporate Customer 2800 US Highway 1, Aero Beach, FL 32960 Relations Amc rm lilmderxul Swam cl Ftardi. n_ L¢enw If CMC11249753. CACo45678. CFC1428283 (866} 803.0879 CUSTOMEREMAIL CC�¢4LLLL S /O •7 AODRF,$,S r-lTY !P HOME PH94F,, CELLPHONE 1110Rr.PHON- YOUR HVAC SYSTEM DES"GN OPTION 1 OPTION 2 OPTION SIZE yT TYPE ' 3, TYPE Cir r�r�-tom SIZE TYPE 6L, n ' EFFICIENCY � ;FFICIENCY/a Sir- EFFICI NCY $ 7 $ >T�sr G $ 13 $ —�i C• $ 7�..71� --'Lm $ $ $ �$ $ SUBTOTAL $ 6� SUBTOTAL $ %p.? 5U OTAL $__7qm l - MONT EST • $ MONTHLY EST.' $ NTHLY 5T " $ CU MER INITIALS CUSTOMER INITIALS CUSTO ER INITIALS . arranty: Parts bigbor Warranty: Z-0 Parts �1or Warranty: _ _ Parts Labor Compressor __Heat Exchange Compresscr Exchanger __ Compressor __._...,_Heat Exchanger Refrigerant recovered and disposed of as required by law. omplele clean up Including use of floor savers to protect your home and removal of existing equrpmenL All work completed is done in accordance with existing codes and permits, as requ red. SPECIFICS OF • • SELECTED DPTIDN: ❑ 1 ❑ 2 Q3 ❑ Weatherproof Connect to Existing ❑ Electronic Air Cleaner _ SUBTOTAL $ O �o Disconnect Electrical ❑ Media Filler.. _ J Ufetime Equipment Slab _ _. _ ONew Plywood Deck ❑ PCO $ �efsound Isdation Pads ZReconnecl Drain Line ❑ UV Light ❑ Liquid Tie Condu 1 ❑ Ceiling Saver Kit ❑ Humidifier as ❑ Start Kit {Pan & Float; © Dehumidifier TOTAL $ Refngerant L.L. Dryer ,Al Main Drain Safety Switch ❑ Outdoor Unit Pad ed Refngerant Pipe Seal New Connections ❑ Hue Venting PAYMENT ❑ Now Afieconnect ❑ Support Attic Equipment ❑ Ductwork Connections ❑CASH ❑CHECK# Refrigerant Pipe Cover Pf Supp�Y Plenum ❑Fuel P'p ng ---_---- Ff Expansion Valve ❑ New Reconnect ❑ Electrical Wiring EDIT CARD (LAST 4#s) ,PT -stat --Type Return Plenum Jaltoma Semse Plan - E3 New Reconnect P— 1 Term (364 days) EXP APPROVAL . OUR GUARANTEES Comfort Guarantee Home Protection Guarantee ❑ FINANCING' 24 Hour Service Guarantee 0100% Unconditional Money -Back Guarantee -Payment opticns available with approved credit NOTES D `J P 7,r -S I✓7511 Written customer authorization will be obtained before beginntng any unforeseen additicnal or extended work. ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 558, FLORIDA STATUTES. • BUYER'S RIGHT TO CANCEL: This Is a home solicitation sale, and if you do not want the goods or services, you may cancel this agreement by providing written notice to the seller in person, by telegram, or by mall. This notice must indicate that you do not want the goods or services and must be delivered or postmarked before midnight of the third business day after you sign this agreement. If you cancel this agreement, the seller may not keep all or part of any cash down paymenL See the reverse side hereof for an explanation of this rlghL • I acknowledge that my right to cancel has been explained to me orally and in writing, and wit arving my right to cancel, I authorize the perfonnanc he wo blecl to all terms and conditions set forth on the reverse sid ieof, p s any taxes upon completion. x L.u,"TOMERSGNATURE L:AIL ZT0MPANXAf4FtPe0A1rVE cuw6MER SIGNATURE DATE E 0 2016 Amo w Resideniial Sarkes LLC All 6ghis reserved. ARS 1076 081715 8250