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HomeMy WebLinkAboutAC CHANGE OU APP 6018 ADONIDIAALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: -_ W 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 FOR•_ rwC PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: lOr Property Tax 1D #: _iyf D '583 -D,? 70 --0))n-G Lot No. Site Plan Name: Block No. Project Name: 000- ia: l w —f2(—v C 4i,4W4C 04-ul Setbacks Front I Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Exact change out �C (,��lit f I �l�f�-l[t D �1t2ik��-- 4%T� I$Sr-Ck 9-,-qr P4A-P -95 VA!'P,o*A'&03ON,rteIVA OO6L CONSTRUCTION.INFORMA_ TION: itiona wor to e erformed under this permit - c ,call M appy: ,HVAC Gas Tank ❑Gas Piping_ Shutters O Windows/Doors 11 Electric 0 Plumbing []Sprinklers Generator ❑ Roof Total Sq. Ft of Construction: ScFt Ft• of First Floor: ❑ Cost of Construction: $ Utilities. Ln�) Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name C Ar p Name: Zacek, Dennis Address:. (001 211 ba A) J b Imo_ _ L Company: American Residential Services City: *rt pie.rm State: FL Address: 2800 US Hwy 1 Zip Code: 3 L977- Fax: NIA City: Vero Beach State: FL Phone No. -) -)a _ V69—bQ'?_7 Zip Code: 32960 Fax: 772 794-9783 E -Mail: NIA Phone No. 772 794-7221 Fill in fee simple Title Bolder on next page (if different E -Mail: bderby@em-sem Cc -er iso &0TS -C-&.A- Cti.A-from from the Owner listed above) State or County License:-6fe"28205 ow IDY 9 7S' If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 06t W,i( �l/oA� SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: EER: i Not App Name: Address: City: Stater Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: _ Address: City:_ Zip: I certify that no work or installation has commenced prior to the issuance of a permit. Phone: St. Lucie County makes no representation that is granting a permit will authorize thepermit 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; vour Notice of Commencement. Signature of Ow essee/Contractor as Agent for Owner Signature of Contra or/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF STLUNE COUNTY OF STLucol: The forgoing instru ent as acknowledged before me The forgoing instrL was acknowledged before this day of . 20 "bs3 y thiL day of 20 a by DENNIS EK 1 (NarR ofpers e-d Notary blit- State of Florida ) Personally Known xxx OR Produced Identification Type of Identification Produced Commission Norte' ' .�,( eaI) THOVAS H. DAB DENN S (Name of Not'arpublic-StaWof Florida ) me Personally Known xxx OR Produced Identification Type of Identification Produced rr G Q4 r * H. pADlaM * Commission No.�o°�'T��ptl13LlC j, NOTA. C i'LOR1DA WIds; = ruo�.i GCS =�rLCo=*FF1_4W+.r f115/q0?4 FLOI o r 217-01 S CaTKTOFM28494 •'ters&0•si EXPIc ' .-a G pires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Healing • Plumtlil l9 • Air Est. Start Data Installation Work Order Est. Completion Dale (772) 567-3100 Corporate Customer 2000 US Highway 1, Vero BDach, FL 32960 Relallon,9 Arremnq Rrslrlentud SLnxrs of FkxM Inc License. ! CMC l249753. CAC0458M CfC 142£1203 (866) 13030879 CUSTOMER EN%IL CALL. SUP ADDRESS Q1,Y Ada, Ci r7STATEIZIP HOME PHONE / ,4 _ 40E—OI7 C4.LiP{0JCj, a4_X�2��y WORKPHONF YOUR HVAC SYSTEM DESIGN OPTION 1 OPTION 2 OPTION SIZE -!K TYPE r- lC/' SIZE TYPE ` SIZE TYPE EFFICIENCY" EFFICIENCY EFFICIENCY r� //• ,Z, $— 210 I 3 �'J /l $ �OP��•v $ . . y, �lr $GdG $ - -- - - - $ $ $ SUBTOTAL $ SUBTOTAL $ SUBTOTAL $ MONTHLY EST.' $ 6 MONTHLY EST.* $,_ MONTHLY EST.' $ CUSTOMER INITIALS CUSTOMER INITIALS CUSTOMER INITIALS Warranty: _/U Parts �01 _- Labor Warranty; Parts Labor Warranty: Parts Labor Compressor _ Heat Exchanger Compressor Heat Exchanger Compressor —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 IMMUMPTeTuNTM; ©M❑ 2 ❑ 3 Weatherproof ❑ Connect to Existirg PkIectronic Air Cleaner F-- SUBTOTAL $ isconnecl Electrical ❑ Media Filter _ PLifelime Equipment Slab PkNow Plywood Dock ,jXPCO ---- �- $ n Sound Isolatiun Pads ,)I Reconnect Dra n Line AUV Light voeW/'& C3 Liquid Tite Conduit 0 Ce mg Saver K-1 ❑ Humidifier _ ❑ Start K+t (Pan & Float) ❑ Dehumidifier TOTAL $ ❑ Refrigemrl LL Dryer 1AMain Dram Safety Switch ❑ Outdoor Unit Pad KRofrigerant Pipe A Seal Now Connections 13 Flue Venting ❑ New ,Reconnect 0 Support Attic Equipment ❑ Ductwork Connections ❑CASH 0 CHECK# *efrigerant Pipe Cover jo Supply Plenum 0 Fuel Piping 0 Expansion Valve ❑ New kReconnec.t Electrical Wiring t� CREDIT CARD (LAST 4#s) t OTH2O stat -Type/ y�lcoturn Plenum f �: ❑Now I�'Res,onnecl 9'Home Service Plan - 1 Term (364 days) EXP APPROVAL • - GUARANTEES '+ r} Guarantee ome Protect Guarantee ❑FINANCING' 42 Ocomforl 24 Hour Servlr.o Guarantee X100 Unconditional Money -Bach Guarantee 'Payment options available with approved credit r SII z4a " f !L R7w/7 - / E., An- J�ij7 C.., TC !K•!Lf'� "1� IS- " .Z, rI -oL g 9 • Wr'llon customer authorization wd be obta!ned before beginning any unforeseen additional or extended work. • ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 55B, 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 mail. 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 payment. See the reverse side hereof for an explanation of this right • I acknowledge that my right to cancel has been explained to me orally and in writing, and without waiving my nght to cancel, I authanze the performance of the work, subled to all terms and conditions set forth on the reverse side hereof, plus any taxes upon completion. Notice To Owner - Do not sign this home improvement contract in blank. You are entitled to a copy of the contract at the time you sign. Keep it to protect your legal r•ghts. This home improvement contract may contain a mortgage or otherwise create a lien on your property that could be foreclosed on :f you do not pay. Be sure you understand ell provisio s of the contract before you sign. ,; . r - C.I .TOMER SIGkA ' _ DAT€ OMPANY REPRESENTAINE CUSTOMER SIGNATURE DATC DATE 0 71117 Am—, P� l� iL l 5...•:, I 1 r: All r..A,l....•...n. i AR.Sinin n19,01117 R7190L 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: 9892751 Date: 7/28/2017 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: 25VNA048A*030* Indoor Unit Model Number: FE4ANB006L+UI Manufacturer: CARRIER AIR CONDITIONING Trade/Brand name: CARRIER AIR CONDITIONING Series name: INFINITY 20 HP with GREENSPEED INTELLIGENCE 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): 47500 EER Rating (Cooling): 13.50 SEER Rating (Cooling): 18.00 Heating Capacity(Btuh) @ 47 F: 45500 Region IV HSPF Rating (Heating): 12.00 Heating Capacity(Btuh) @ 17 F: 47500 ' Ratings followed by an asterisk (') indicate a voluntary rerato of previously published data, unless accompanied with a WAS, which indicates an involuntary rerale, 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 disciaims 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 Certlfieate. 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 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 & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.anddlrectory org, click on `Verify Certificate' link %%v ivake lire helter- 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 rlghL ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131457309987365419