HomeMy WebLinkAboutBuilding Permit ApplicationRCI. NPruCABLE INFO MOM 1 BE COMPLETED FOR NPPCIDITION TO Br,CCEPI Eu
P-rmit Number:
tsuilding Perm;t Application
Planning ansa v�v-,�rment Services
Building ana C -a- x-yularion uIvision
231515 virginia A7m,., Farr Pierce rt sziydd
Phone: (rrz)86&1553 Fax: (7ic) z;oZ-15i8
PERMI i APP4CA I ION FOR:
PKUPOSED IIVIPRUVWENT LOLL i -0.N' :
CC;""117cFcidl. Residential x
Address: ZiBo 1� h Sit S
Legal De,cription: I- R r; 4- .� aL(-.--
Property lax ID 3n 1 - 6z-, — o?_zI — D-
I:aC IVv.
Sipe Plan 19amc:
Project Name: �
Setbacks
Front_ Back: Risht. Side: Left Side:
DETAILED 'M5 OPTION OF WURK:
Exact Fhange flat of 7FF 11/1,T
t
CUNSTRUM I LuIQ INPURMATIGM:
na wor Lo a aaormw lin o;
slocR Mo. YR
installed M Ot ire 3 TIS N I LI S -,r° p
-- - -- -..� r.�.....� - �nc�n auMarlotters
aMplr:
_HVAC was Tank ❑G.,, Piping _ wi..dows/Doors
Electric �Pia ... bins L_Iapri�Rlers 11uencrator
I'SOOT
101-1 by. Ft of ConWuMion: S. F�. or First Floor:
Cost ofConSLrucrion:5 'Udlides:11*3cwerL.JSepzic BuildingHeig hL:
uwI9Ex/EE5SEE- ,..,..�. _
Name "'7r,, -
Address: oWlf Sous y2�
City: State: FL
Zip Code: Fax: NIA
Phone No. Q - 3S`g -
E -Mail: NIA
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
it value of constructe.. ii.
Name: Zacek, Bennis
Company: American Residential Services
Address: 2800 US Hwy 1
City: Vero Beach State: FI -
Zip Code: 32980 Fax: 772 794-9783
Phone No. 772 794-7221
E-Mail-�Ge�ars:soa ci of ko ® CtrS, Wkq
State or County License: M8=2826& f V- Ia � 975 -
or more, a RECORuED Nodce or l:omincn«men► is required.
SUPPLE=NIEKi AL UoNSTRU�,I lulu LILN UW IRFUItMA I IDN:
DC.-JUi rR/ENGINEER: x Nut Applit:ab I ee
Name:
Address:
City: State:
Zip: PhunC;
FEE SIMPLE TITLE HOLGI;rt: x Nut ApplicaOle
NamE:
Addre3s:
City:
cip• Phone:
MORTGAGE C0I171rAnIY: x Mot Applicable
Name-
Addr=ss:
City: Mate:
4ip: Phone:
BONDIIoG COMPANY: x Not Applicable
Dame:
Adaress:
City:
ZIP: . Phone:
I certify that no nark or installation Mas commenced prior to the bzn.mce of a permit.
z,t. NJ= Count- makes no repre,o,,tation ►hat is granting o Permit will authorize me—e, mit holder to 51-100 tMae aB;e,% strutaure
which is In cont tt with any a plicaule Ro... c Owners m5sociation rel. , Bylaws or and coven—t, that may restrict or pronigit such
.tru,,ure. rlease conselt ..It your Home Owners As,vmation and review Your d.c
In rontideradon of the granting at this reyueste'a perm:t, Ido hereby agree tnat I ,will, in all respects, pefro rr any restriction. n tfiic work may Iy
in accordance with til- ap,,,oved plans, me FleriU. tseilding Codes anti �t. Ilan County mmenumeFit...
he following 50[1:n6 permit app,ication. ora caemp, from un'aergoinisa tell concurrency re -.i o :: room additions,
o��e�ao� yy structures, swlmrning pools, fences, walls, si6n„ green rooms anti ac�e,.o; y uses to anotner nen-, aAen,ial use
WARNING TO VvVtvtR: Your failure to necoro a Notice of Commencement may result In yoar saying twice for
improvements to yoar property. A Notice of Commencement mint be recorded and pUsted an tie lobsite
before the first insFection. If you intend to obtain financing, con,ult with lender or an attorney before
COnri—nericing work or recordiner & tour NOtice Or Cortlt lEncement.
21
5igna,u ee of D, er/ Le.,�e-/Agent
a i A I t: OF FLORIDA
COUNTY Or sie...
� Jgrpoi.,g in,tru nt was ac nowj�8sec fore me
this is day of
1 011mis Zacek
ame Z:;an.cknowIedgIng)
1
l ig ..ter- of Notary PUBI!c-')tot, of Florida )
Personally Known - OR Produced Itiendncot:on
I ype or ltient:tication Produces
Comm/„Ion NQ, fI-i-r?q 9 L:(SealL invmr+) H. O!
Revised 0//15/2014
REVIEWS i- ONT
COOM I ER
DATE
COMPLETE
IRI I IMES
SignPte- LOT Contra r/[Iccn,e Rolder s
STATE OF FEURIDA
COUNTY OF site im
The forgoing insir tilt �.as nowletigea Beat me
tlil5� �y a ZZU by
Dennis Zecek
(lQameof erson acKnowleBgi.g )
0
51 naotary
ruBCe- 5tute of Florida
Personally Known x OR Produceti ItientifirAon
I, pc atl8entificaLion rrotiuc�is
ammission Ivo. FF22099a �i
w Q1�kiElci%D
” 4 STAY E Ch- :QED Z0.'%
�.•� s t r ,mss: FiZy:'
ZOIviIVG SUPERVISOn PGRRS
KEVIEW REVItw REVIEW
1 il'` 'M
�or�-r# �r'+co•.SA
VEGETA IIt71v 5EATURTLE MIARGROvE
REvIEW REVIEW I REVIEW
A'
Haling • plumhi
�-� •� ` N�'�` � y per- �
Est. start Dale -SX
Installatw�
rr rK armor Est C�iwpletia�. D..ta
(/ /Y) 05/-3 10-0 Corpo ate Coalomor
2800 US High -ay 1, Vcre Be..cai, FC 32964 Relohene
..,,:r�fzern;ae..,...rywolFlore�;n:.Lice,esCl�dC1,49/FSCftCi}15E3'1'B,CFC1•f?82&"3 1'866] 803.0879
cea �raeR �� � Q � err4 as!•
..vene..a ci TEdZ
HO D
CELLPHOnL .runK.P.onc
OPTION 1
DESIGNYOUR HVAC SYSTEM
OPTION 2
OPTION
SIZE . —3, TYPEr/,�
sIZEy�:r TYP /
SIZE '--� TYPE
EFFICIENCY -_
EFFICIENCY
EINFICIENCT
fiAll
SXR
SDBrumA/INITIALS
SUBTMAL 5 }
SUETOTAL y _ r
MCiNTHLY E5T.• 5
MCWHL$
MONTHLY T" $
�.UaTOMER IN IT IALS
COSTO
CUSTO ER INITIALS
W..rr..n:y: _ P.m. Labor
W..r nly: L} Partv Labor
W only: _�O Porto Labor
_j � t omprc —r GHeat Exchaeg•r
Heat Exchanger
" wmpressor--_-- Heat Exchangor
Ralrigumni .ecovered .nd disposed of ..o r..quimd by Ir -r- C:omplalo elo.n op inoleding gee of gee.- =o e.., to preleet year hese a .d
removal u, uxisring equipmonr All wm k Gomp6tcd in don.. in avc..rdonce ith oasting codes and permila, ..a required.
SELECTEe OPROrv: Rf 1 ❑ z ❑
❑ Wealherproo. 211tunnact to Exia7u,g Wecrroma Air Cte..nor _
SUBTOTAL $ tet" Q
Disconnect Electdi:al ❑ Mod a Fiilor
I
;ifelme Equipment S ab ❑ Ne- Plyw—d D��k u PCO
5 40W.--- ---
.42r5ound Isolation Fadr, .BFieconn.c; Dran•, Line u UV Light
0 Liquid Tilo Conduil Ceiling Saver Kit 13 Homidifiep
(P.,n & Flaatl
E3 S:an Kit ❑ D�chem;d:fier _
TOTAL
Ant-nefrigerant LL Dryer ,oilllrWn Drain Salo,,, S -itch ❑ Outdoor Unit P..d
A:rRvfrigert.nt Pipo .0'Teal Now Conna,:l ons ❑ Floc Venting
❑ Now �FRcca .ncot ❑ Support Allis Equ pmepri 0 Ductwork Connections
G CASH u CHECK#
RMefngeraril Pipe Cover Atupply -len}�m 0 Fuel Piping
❑ Expons-or Vail... 0 Now Zconnu.-A 0 El-ctnt al War ng
E3 CREDIT CARD (LAST 4#s)(p g
1 Melanin Plenerri'Hwma 5.rpplea Plan -
.ffTbraT-Type LJ No.7ooannvel 1 Term (364 day=)
EXP APPRC-IAL
■ GUARANTEES •'
i,emferl Guarantee �hlome Protection Guar. nioa
u FINANCENG' �
4 Fl- Scrriee Go -r -riles p 10 Back Guarantee
P., r nt apt oir_--�_ilrblo =th �.pmTed credit
T&' •
• Wktt=n a-zslumn; Iharizalion will be obtainedbolora beginning any unforeseen adMonal or extended worR
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJEUi TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 558,
FLORIDA STATUTES.
• BUYER'S RIGHT TO CANCEL: This Is a home solicitation sale, and it you do not want the goods or services, you may cancel
this ..graornwrit by providing-rittae native t= the seller in person, by telegram, or by mail. This notice must Indicate that you
do not :ant the goods or zer riee-z pnd ono -t be dJI-;wred er pa..twlerkad bef■p• midnight of the third business day after you
sign :hie agrbo.�.anL If you cancel thl- agroomant, the ..offer on -y wet kewp ell or port wt on; each de -w p.;7unent. See the
reverse slue.rarovTfor ..n e..plAnotion of this sight.
• I acknowledge that my rignt Tu cancel has boon axpl..u.ed to me orally . nd in :riling, and without a.:..g my ght to aanael, I-811heri_e the
performance cl the work, subject to all terms anu :'.onoihwns sot tonh on the re -corse aido hereof, plea .any laacs open c.mplalion.
Native To O .mer - Do not eign Thio home irnp;�.-emerrl eaAr-at in blank. Yon -e anlllled 1= a aa,:, nfjbq contract at the lime you sign.
Keep it to protect your 6go1 rights, This home imprevcmonl �onln,at may-a..tniR a mortgage ep a nrr era(= a lien on ;=u property
ins ..0010 lm rcr0aloacd on it v.o do no: Pay Ba acro you ondoratu d ..11 pre.wepris of the an at of you mgn.
,;tp U sill f a=111P..NY REP ENTAT
410
U TOMER S$GNATU CnoE o^,G
u.el-..mnicnn-nmunn1.1..-en L!- -„hie +e■o.rod. AR2: �.�.'r [?5a8t7 8250
Certificate of Product Ratims
AHRI Certified Reference Number: 9543716 Date: 8/17/2017
Product: Split System: Air -Cooler! Condensing Unit, Coil with Blower
vuttioor Qnit: Mouei ntumEer: c4mCC4u3A*Oa0*
Indoor Unit Model Number: F84CNF036L
Manuiaciurer: CARRIER AIR LGAOI I iDivlA'u
Trade/Brand name: CARRIER
Region: Southeast and North (AC, AR, DC, DE; FE. GA, RI; KY, Imo{, MO. RIs, i4C, On, zC, i N, i A. VA
AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, Mir MN, MO, MT, ND, NE, NH, NJ,
A T r OR, OR_ rm, RI, 311, 0 1, v I, vvA, VV V, vtll, vv T, u.a. I erritories)
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 insialiea in region(s) Tor w1IlcFI tney meet the regional ernclency requirement.
Series name: COMFORT 14 AC
Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING
Rama as Tollows In accortiance whit ARKI atanaara c-iOrieeQ-zU0a Tor Unitary Air-Conaliloning anti Alr;5ource
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 33000
EER Rating (Cooling): 12.00
sEErt Rating tCoolingy IZ00
IEER Rating (Cooling):
R.angs follewoo By - :.a! -rias (') inoicam .:olanwry ren to of p:e:iousiy peWi: ,ov a -!a, e. -,los aceemp-.-,loo me! . -.,S, ;TRIM inoiwlos an Imalertsry rarelo
DISCLAIMER
AHRI does not endorse the productisf listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes rr_ rasp.1lslblht, for,
tRa prootrczisy l6wo gn lila MRI expressly gird-alms.1111.11lllty,ur oam.gas gr any Ring .d.ing .or gr ,n. oro or parrurmanca gr the pr.ducr[s, ar ine
seaethwri_ad . to._tl.e of d_t_ listed on this Cerllfla_te. Certified r-tings ar.:_Ild only for rn.dclm and e.nflger_tivem Ilsted :n the
directory at www ahridlrectory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and MID P
cenfidan:i..l rofaranta perpases. Thu corrania of :his Conifica......y moi, In whale or In port, eR reprodo..eo; —plod; dlaeomin.,ad; '"- tin `
nrt_r_d i -to . e.rwReto d_t_b_o.: =r ■therwim etlll_.d. is -R,- ferry .r rrt-Rnr. or 4y -m7 —9 -no, _�"pt far th. c�r'o I_dlcldP_I,
personal and cunnoentl.l rerarenee. A1H•aa1ralaoltlR. nt •o
CERTIFICATE VERIFICATION s REFRIGERATION INSTITUTE
Ina inromtailun,or tiv mogul cltoo on .lis cerilnu.te c.n N -rcrhmu ., wrrmaRrl.iractary ori;, ,.II..R on '7crlTy rcrtlrl....,c' Unit
and anter the AHRI Certified Rafarenoa Nemb.r _nd the dal. am -hieh thy-artifi.at.:a, based.
which is listed above, and the Certificate No., which Is listed at bottom right. 13147444743ov42124
'vA.r_-r mir-Contlitloning, Beating, anZi nealgeration Institute CERTIFICATE NO.: