HomeMy WebLinkAboutBuilding Permit Application APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.te: /� C ,+7 Permit Number: f �C0 0a
Building Permit Application
Planning and Development Services JUN 13 20v
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
,.. . __. IT;EPPROVE
O.NW.
Address: -76 G 3 it r&" _1i`v''ch_r"
egal Description: 1A kv— LcJc�7 , 6
+-
PropertyTax ID#: Lot No.
Site Plan Name: Block No.
Project Name: C<
Setbacks Front Back: Right Side: Left Side:
DETAILED DEk- TION OF,,W0R ' �� e
n+ r . .... . ._ . �.a... .
EXACTAC CHANGE OUT NO DUCTWORK--- (Waat-2(L- �� S` 6 '�'fL,
08O fivr-, Q4cc63o�4 'o. ,
ACCIttional work to Derformed under this permit—check
.all that appy:
R HVAC I_I Gas Tank []Gas Piping _Shutters Q Windows/Doors M
Electric El Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ Z z ` Utilities: Sewer OSeptic Building Height:
OWNER�LE55EEr xCONTRACTOR
tu-.xati'e.�e.,.£s.�......,• SAa r`»+ :�aae...-x.� Liw:r �.aT«w.o.x...'_w`va.c ,-�
Name_ t f.G ri �� l ✓+'ice Name: DENNIS ZACEK
Address:-7 ::;03 i r 1, �� r�,} Company: ARS
City: Y`� J�� � State:'rL Address: 2800 US HWY 1
Zip Code:3 LICI !:0;'( ; Fax: City: VERO BEACH State:FL
Phone No. 6- Zip Code: 32960 Fax:
E-Mail: Phone No. 772-794-7221
Fill In fee simple Title Holder on next 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.
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SSU !EIVI N�A OxNSTRU lNLlEN�I.gWN RNi4T1 y N mF
DESIGNER/ENGINEER:
Name: MORTGAGE COMPANY: x Not Applicable
Address:
City: ..� Address:
ZIP
Phone: Sta City State:
Zip•. Phone:
FEE SIMPLE TITLE HOLDER: x of Applicable BONDING COMPA
Name: Name: !—_Not Applicable
Address:
City: Address:
City;
Zip: P one• ZIP; _Phone:
i certify that no
work or installation has commenced prior to the issuance of a permit.
whichcis to conFl(ct wltii any applicable Home Owners tAssociationirulesauthorize r and covenants that build
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
.com.mencine work or recording vour Notice of Commencement.
•
_Signature of 0 er/Lessee/Agent. .. -
ATE OF FLORIDA
COUNTY OF sires. COUNTY OF siu,de
The forgoing Instrument was acknowledged before me The forgoing instru ent w=acknowledged before me
this day of ZO 1by this S'Cl day of ZO b
e Omnis Zook Dennis ZaWk
(N a 6f person ackno ed ing) (Name of person acknowle gi g)
(Signature of otaryPu lic-State Florida) (Signature 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. FF220M (Seal) Commission No. FF2M30
y THOMAS.H.DASMKO Y140(�p� .BA61190
M. C NOTARY PUBLIC
Revised 07/15/201
STATE OF FLORIDA
Cmtr#FF128494 Carro FF128494
Expires 6=018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
LLDATE
a � I
. J
ERT��!E This combination qualifies for a Federal Energy
AMP Cr Efficiency Tax Credit when placed In service
between Feb 17,2009 and Dec 31,2016.
Certificate of Product R
AHRI Certified Reference Number.9176716 Date: 5/30/2017
Product:Split System:Air-Cooled Condensing Unit,Coil with Slower
Outdoor Unit Model Number:24ACC630A*030*
Indoor Unit Model Number: FV4CNF002L
Manufacturer: CARRIER AIR CONDITIONING
Trade/Brand 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 nam e. 16 AC..
Manufacturerresponsible for the rating`of'this system'combinatiowls CARRIER AIR.CONDITIONING
Rated as follows in accordance.with AHRI Standard 210!240-4008 for,Unitary Air-Condittoning and'AI�Source
Heat Pump'Equipment an&subject to verificationlof rating aacuraevzby RHRI=sponsored,Independent;'third
party testis .
g
Cooling Capacity(Btuh}: 28000
,EER Rating(Cooling):„ 113.00
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 an 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 tie used for Individual,personal and
eonfidentlat 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 &REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at www,ahridiFectory.org,.cilck on'Verity Certificate-link ee make life tether"
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 131406150467413367
02014 Air-Conditioning,Heating,and Refrigeration Institute [ CERTIFICATE NO.: