HomeMy WebLinkAboutScanned from a Xerox Multifunction PrinterALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �S--- I S —/ 7 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION: n
Address: r ' ,04'(Z7 J --Z :3 c�r
Legal Description: IHS <gfC3J).?__ acmelGM!_1 ram! 'C 7 Q%7 /
Property Tax ID #-._!39j j 0 -607 — 01 -� ��O" �Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: 1
EXACT AC CHANGEOUTNO DLLCT
6WR4t&,
Name Z
Name: DENNIS 7ACEK
Address: t5:::Jt!rE�p -)ua A_hAgr t e, %/
/WORK-
City: ��XL'� �I+GE`C2 Stater
Address: 2800 US HWY 1
zip Code: 3y1177_ Fax:
City: VERO BEACH State: FL
I=BLICI� C4zy
I -
CONSTRUCTION INFORMATION:
Fill in fee simple Title Holder on n -page (if different
E -Mail: TDABERKO@ARS.COM
Additional work
R✓ HVAC
tobene Orme
L Gas Tank
un er t is permit - c ec a
❑Gas Piping
appy:
Shutters
❑Windows/Doors
_I
_
Electric
0 Plumbing
[]Sprinklers
Generator
0
Roof
Roof pitch
Total Sq. Ft of Construction: S. Ft. of First Floor:
Cost of Construction: $ -- _� Utilities: Sewer ElSeptic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Z
Name: DENNIS 7ACEK
Address: t5:::Jt!rE�p -)ua A_hAgr t e, %/
Company: ARS
City: ��XL'� �I+GE`C2 Stater
Address: 2800 US HWY 1
zip Code: 3y1177_ Fax:
City: VERO BEACH State: FL
Phone No -_7a?'�
Zip Code: 32960 Fax:
Phone No. 772-794-7221
E -Mail
Fill in fee simple Title Holder on n -page (if different
E -Mail: TDABERKO@ARS.COM
from the Owner listed above)
State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LiEN LAW INFORMATION:
x Not
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Nat Applicable
Name: '—
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State-
Zip: — Phone:
BONDING COMPANY:
Name: _
Address:
City:
ZIP: - Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
x Not Applicable
St. Lucie Count yy 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
commencing work or recording our Notice of Commencement
_ Signature of owiYQ Lessee/Agent
STATE OF FLORIDA
COUNTY OF st.auwe
The fo Din instrum t was acknowledged before me
this day of 20[_'7 by
(Name
Dennis Zacek
of Notary Public- State o
Personally Known x OR Produced Identification
Type of identification Produced
-- . Y --
Commission
Commission N<
Revised 07/
REVIEWS
DATE
COMPLETE
ETE
INITIALS
NOTARY PIQA
STATE OF
PE12Ba94
E*
i �r-r`ti s
Signature of Cont or/License holder
STATE OF FLORIDA
COUNTY OF SiLuce
The forgoing instrument was acknowledged before me
this day of 20l_7by
Dennis Zacek
(Name o person acknov
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of identification Produced
Commission No.H'
'fHd y pLii
t STA'; .. LOfu A i
FRONT I ING
COUNTER REVIEW W SUPERVISOR REVIEW REVI W VREVIEWON S REVIEW E REVIEW VE
•=�`� z Y //Q �� 7 Est. Start Date
0;00 Inst lafion Work Order Est. Completion Dates
(772) 567-3100 Corporate Customer
2800 US Highway 1, Vero Beach, FL 32060 Relations
American Res dential Services o1 Florida Inc, License # CMC1249753, CAC045878, CFC 1428203 (866) 803.0079
SIZE 0�/ TYPE eo-rCii2r
EFFICIENCY — ��;6'10�,Ct^
$ Z2,
c. $ z
$?s
$
SUBTOTAL $9
MONTHLY EST." $
CUSTOMER INITIALS
EMAIL
CELL
SIZE c,/ TYPE SIZE-- .2— _TYPE
EFFICIENCY ,/�� r EFFICIENCY
$
$ -.moo $ -i—
$ $
SUBTOTAL $v SUBTOTAL $
MONTHLY EST $ MONTHLY EST* $
CUSTOMER INITIALS CUSTOMER INITIALS
Warranty: 0 Parts 'I Labor Warranty: �_ Parts L Labor Warranty � Parts � Z Labor
�QCompressor Heat Exchanger AcaCompresnr.r Heat Exchangor /10--nmpressor Heat Exchanger
Refrigerant recovered and disposed of as required by law. Complete clean up Including use of floor savers to protect your home and
removal of existing equipment. All work completed is done in accordance with existing codes and permits, as required.
SPECIFICS OF •UR INSTALLATION SELECTED OPTION. ❑ 1 ❑ 2 ❑ 3
❑ Weatherproof
Disconnect
,Mfelime Equipment Slab
Alsound Isolaton Pads
❑ Liquid Tile Conduit
❑ Start Kit
$Refrigerant LL Dryer
MRefrigerant Pipe
❑ New $Reconnect
JaRefrigerant Pipe Cover
gMpansion Valve
OT -slat -Type
ltonnect to Existing
Electrical
❑ New Plywood Deck
$Reconnect Drain Line
Rteung Saver Kit
(Pan 8 Float)
.0 Main Drain Safety Switch
.Meal New Connect ons
❑ Support Attu: Equ pment
,Mupply Plenum
❑ New j2Reconnek.t
2 Return Plenum
❑ Newer Reconnect
❑ Electronic Air Cleaner
❑ Media Filter
❑ PCO _-
❑ UV Light — _
❑ Humidifier
❑ Dc humidifier
❑ Outd-.w.r Unit Pad
❑ Flue Venting
❑ Ductwork Connections
❑ Fuel Pip ng
❑ Electrical Wiring
JB*Fiome Service Plan -
1 Term (364 days)
-0 Comfort Guarantee i Home Prote_tion Guarantee
Z24 -Hour Service Guarantee Ja'100% Unconditional Money -Back Guarantee
5UBTG L $ �. �L
$
TOTAL $
❑ CASH ❑ CHECK# _
OREDIT CARD (LAST 4#s) Yr;? 9
EX/P� APPROVAL
f�FINANCING', ,m
'Payment options available with approved credit
I acknowledge that my r ghl to cane has been exp ained to me orally and in writing, and without waiving my right to Cancel, I authorize the
performan a of the work, subject to all terms and conditions set Icrth on the reverse side hereof, plus any taxes upon completion.
Burets Rlghl to Cancel: This Is a home solicitation sale, and if you de not want the goods or services, you may anal this agreement by providing written notice to the
seller In person, by telegram, or by mail. This notice must indicale that you do not wast the goods or services and most be delivered or pmtmarked before midnight of The
third business day offer you soja this agreement. IT you cancel this agreement, the seller may not keep all or part of any ash down payment See the reverse able hereof
for an esplanal on of this right.
Negro To Omer: (e. Ifo riot sign this hone improverm nt cwrbact In blank. (6. You amp entitled In a copy at the mohad at the lime yon sip1L Keep It to prefect you legal rights. (e This home
jalpmeeuel lain a mortgage or oberwlse ovate a gen of yxr properly that maid be lorede3ed on it Tendo Be sum you understood all prarhiors d the contract
belIrZJ
� /
CU EH{IGNAIURE �&_GATE GpMNA ATNF
CUSTOMER SIGNATURE DATE DATE
C 9016 Amerman Residential Sermon LLC. AN n61rte reserved. A"v.' I OM 061' t 5 8255
SLG
Property Card
Page I of 1
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser — All rights reserved.
Property Identification
Site Address: 5800 SUMMERFIFLD CT 47A
Sec/Town/Range: 10- 36S,40E
Map ID: 34`10A
Zoning:
Ownership
Debra A Arze
5800 Summerfield C'I'
Fort Pierce, FL 34982
Legal Description
THE GROVE CONDOMINIUM -SECTION ONE- UNIT 47A (OR 3656-
2983)
Current Values
Just/Market Value:
$57.000
Assessed Value;
$46:926
Exemptions:
$25.000
Taxable Value:
$21.926
Taxes for this parcel:
SLC Tac Collectors Office p
Download TRIM for
this parcel: Download PDF 12
Total Areas
Finished/Under Air (SF):
Gross Area (SF):
Land Size (acres):
Land Size (SF):
Parcel ID: 3410-507-0185-0004
Account #: 40488
Use Type: 0400
Jurisdiction: Saint Lucie County
This information is believed to be correct at this time but it is subject to change and is not warranted.
a°• Copyright 2017 Saint Lucie County Property Appraiser- All rights reserved.
http://www.pasIc.org/RECard/ 5,1' 12.%2417
Certificate of Product Ratings
AHRI Certified Reference Number: 9764468 Date: 5/12/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 24ACC424A•030'
Indoor Unit Model Number: F134CNF024L
Manufacturer: CARRIER AIR CONDITIONING
Trade/Brand name: CARRIER
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: COMFORT 14 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 (Btuh): 22800
EER Rating (Cooling)- 11.50
SEER Rating (Cooling): 14.00
IEER Rating (Cooling);
Ratings followed by :m asterisk (') indicaio a voluntary rerale of previously published data unless accompanied with a WAS, which Indicates an involuntary cerate
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.ahfldlrectory.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, HEATING,
CERTIFICATE VERIFICATION
6 REFRIGERATION INSTITtrTE
The Information for the model cited on this certificate can be verified at www.ahrldirectory.org, click on 'Verify Certificate' link
,44 make hfc bel er-
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. f`
@2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.:
�3139061803993999t569