HomeMy WebLinkAboutBuilding Permit ApplicationACC APPEICABEE IMFO Mub i BE tOl41PEETED FOR APPLICR111011 1 O est ACCtPe EA
Date:
T, Q T -
Permit Number:
Building Permit Application
Pfanning ana aevefopment Services
auhuing anu force Regumrion Division
zyDO virginia Avenue, Fort Tierce rr,5473z
Phone: (r.z) z;M2-.LD53 Fax; (772) 462-1578 C%-jT'mrTlcrcial Residential
PERivilT APPLICATION FOR: To Select from drepbcx, click arrow at the end of line
PROPOSED IMPROVEMENT EUC:ATIO19:
mdd ress: 1YQ i' /7;-c: 6,1E 4/ A 4 U rT , erCe , Fz- 1 3 Yv s /
Casal Da�eriptivn: � i� 4 5 hob [ (e LT__ 4vr lei C�U
rroperty i ax ID u: 0 Lot No. q u
-3ite Plan Dame: Block No.
project Dame: (.k%, C 14A 7V e2 ir cvev
Setbacks Front Back: Right Side: Left Side:
DE l AiCED 0E5LrcIPTi—UM uF vvunK:
d�c 1iV-AoGtit- cm.,cZ P .. EX4c7 A)o Q�eTC..�d2
i ss --1a ` f a F.C.) 7 Curt K/C� '.5? 7tvu ePru1-- t>,� C.OiY-7
5D ztca 3 s
CONSTRUCTION INFORMATION:
Additional work toe errornned under this rcrrnit - c ce .11 tftaz;ppl,:
VAC Gas i anR ❑Ga, Pip"n6 _ Anners Q vvinaows/Doors
Electric U PIa-Ding UbprinRlers Generator Roof Roos pncll
f otal 5M Ft or Can�truetion. Ft. of First Floor:
Cost of Construction: 6.y0� Utilities: �Se..er E1)cptie 6ailai.-.g ReigFc
uwNER/LE55EE:
CUM I RAC IUR:
Dame
Mame: V'4rza ,q-fW z GLiG
Haclr���: U CA IT;e ))s JC14&15
Company: yRs
city: r e r tsw State: LZ-
Aaa, e,,: 2 805 0-5 ,LC 2�4 /
Zip Code: 3 k R T 1 Fax:
City: O.D_E> +C3C7 State:,r- L
Pnone Ido. *71 A r' Y3 Z " Y,5 3-
Zip Code: .=5:2 `) z, V Fax:
P11one Ido.
E-IOla;i: kka& �a • i= 044-`'
Fill in fee simple Title Hola�r an next paste i it dincrent
E -flail: ri d 6.z r-(Gc:� 4a --u S . C-0
from the owner listed above)
State or County License: C14V_
If value of construction is $2500 or more, a RECORDED Notice at Comman,ement 13 rcMairetl.
q / 2/7// 7/7
SOPPCEIOIEI9 IAL L;U195I RU iUN MN LAW IMMRMAMUN:
DESIGNER/ EN GI NEER: _ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Nam--:
Name:
Addrers:
Addru5u:
City: State:
City: State:
Zip: Phone:
Zip: t-Rone:
FEE SIMPLE TITLE HOLDER: = Not Applicable
BONDING COMPANY: NULApplicable
Mame:
Name:
Address:
A00ress:
City:
City:
tip: Fhone:
Zip: Phone:
I certiry that no work or installation has commiencea prior to tfiie is3aunc� at o pe. mit.
at. [ude County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with ant a plicable Home Owrie. s Association ralc3, 6yl.r 3 or o,,Cl ca cna is tn..t mur u
e.t�ict or ii.wRiDit scFl
.r. acture. rlease consult wit your Rome Owners Association anti review your Gees Tor any restrictions wnicR may apply.
In consitieration or IRe granting or tRis requesteti permit, I Do Reretiy agree that I will, in all respetas, perform IRe worn
in aeco.-a..Nee .Itn tn. apps;eti pl.n,, the Fleria,. Sailaing 1-vac...na 5[. iacle Covent, A sentiments.
The following building permit applications arc.�cmpt from. a.-,,acrgoinb a tall ooncurre.-,c, rc ie.: roorm aaaitiam3,
accessory structures, swimming pools, Fences, walls, signs, screen rooms ana accessory uses to another non-resitiential use
WARMIRG 10 CIvvMER: Your i allure to RecorC a Notice of Commencement may result In your paying twice ror
improvements to your prperty. A NoticE of Ccimmcncemcnt must be recorded and posted on the jobsite
befure the first inspection. If you intend to obtain financing, consult with lenlaer or an attorney DeTore
commencing work or recording vuur Notice of Commencement.
_ toib.,atere or O er/ Eessee/Agent Signature aT Contra r/C�ce. ase Raiser
STATE OF FLORIDA
COUNTY OF
The for oing instru� �,�� was acknowledse before me
�'�I�, oT lD 6,
STATE OF FLORIDA
COUNTY OF gree
, he forgoing instrument was acknowledged before me
lmi- _ ao, or
A _ ti,
t"nn.a —MR DennE3 Za—k
(Nam f person acknowledging) {flame o eraor� ucKnoYYlcasing }
('i nature of Kot&y Pu ic- state of Floritia 1 (Sign ure of Nota—y Public- State of Florida }
Pepsenall, Known x OR Proaucetl laerifficadon Personally Known x UR Produced identification
eypeof Identification Produced typcvtl&ntiticution Proaacea
Commission No. 7= -ti FF1.2?WDealt mission No, 4'� �l YVY/ [Seal}
i ii�T�AC$ H. ivUA> t
u 1 RKY i5ona_IC
tl0fVtA4 ti. uAtirecw
-' , NOT
Revised 07/15/2014
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W� tib Ewpl= 6121213 B , - r_7r.ier rF128494
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REVIEWS
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SUPERVISOR
PLANS
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SEA TURTLE
MANGROvE
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Review
REvIEvv
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DATE
COrnP[E I E
INITIALS
LKf��
�y�, lnSTallatiOn WO, K 05rder �` Start °o'Q 9
._ �_ ..�� W L �2J 567- 1 u0 Ear. Compl=tion Du;v
ria-b'na . An 2000 U5 m.gh. —y Vero Beech, Cwrporato Comm,
H" ti"Q' FE 32960
Arr+encen R=dMial.-rites or tf. G.� Relations
e11STOMER �OOd'ti•�Cen%��e,�ci248753,fA1;'p4rLL19�Biw,� {86v}803d8�
Em ,ie
EFFICIENCY W -
1 i $ _
$
SURTUTAL $- ,
MC;MTMI.YE5f," $_
CUSTOMER INI I IALS
testi = e
SIZE-. v_ 1 ype
-VIER INITIAES
Wo+ranty' _(n
- StzL*
TYPE
� Y
"Sound Isolation Pada
Ueeenncc, Drain Line
❑ Liquid Tito Conduit
EFFICIEMCY
❑ Start Kit
(Pan & Fleet)
O Refrige,m a LE Dryer
❑ Mom Drah, Safely 5 -itch
Refrigerant P;pc
❑ Seal Ne- Lenncctiuns
0 Ne- Wh'ccvr'nect
G Support Attic Equipntorit
❑ Refrigerant Pipe Cm c,-
ouppl, Ple.,e,,,
C Exp-ncie,. valve
G Nea kRoconnect
Tat-Typejr} C�ocurn PJ`pelinbures
�f 'vv Fv..M.ct
$
�$
.7Q61 V Ii4C y
-
--�_
5USTOTA1'_
Ti
R17JMTMLr EST.` $
MOIQTNLY Ea I. `
T,
CUS1LjlMtR IRITIALS
-UST
p- -0 1 �a8e,- Warranty: _.._ Parts
�Cvmpressor r,,, Hc. labor Warbnty, _ Parts
t Qchangc• vm ®b,
p .. yr 'neat 0e1h„„ger l+eln re�aor
Refrige.4nt rc-wrcrcd an'o dis _ p - Re t ticcha+rgt
rem.7-I of v�iari, rg equip
-ant. AA rk completed d . dorm m accoC-mpled nee ;eh x st ng code.- �nd permits, as regelmot
HP g p -feed. ,, home and
SE[E%,1r-UpPTIvN: L-11 [32C]3�We.,�, rerproof
Disconnect
onn,.et to Ex.simg
ElavGie�!
etrm,o Equipment Slab
U Nan, Plywood Deck
"Sound Isolation Pada
Ueeenncc, Drain Line
❑ Liquid Tito Conduit
U C.1ing 3a -e, Kit
❑ Start Kit
(Pan & Fleet)
O Refrige,m a LE Dryer
❑ Mom Drah, Safely 5 -itch
Refrigerant P;pc
❑ Seal Ne- Lenncctiuns
0 Ne- Wh'ccvr'nect
G Support Attic Equipntorit
❑ Refrigerant Pipe Cm c,-
ouppl, Ple.,e,,,
C Exp-ncie,. valve
G Nea kRoconnect
Tat-Typejr} C�ocurn PJ`pelinbures
�f 'vv Fv..M.ct
0 ee6.,nrc Air Uearler
U Mxnmirdfifi.r 'a Filt
❑ P
r3 V
0 H
103103
uldoor U..it P -d
13 Flue Venting
❑ Deetwaik Conneclio-,,
❑ Feil Piping
Electrical vvr.,,,g
190.,,9 Service Pran -
1 To.,., (36� days)
iMmf-rt Gear.,ntee IKM�ome I'F--tection Guarantee
24 -Hour 5ervise tiff , n;ce 100% Unconditional Monuy•13ock Guarantee
u (�
SUBTOTAL 3W
TOTAL
❑ Z ASR U CHE%,K#
❑ CREDIT O `�
D JLAST#ssr
EAP APPRUUVVAL
D FINAN I
L%NG` m04
*Payment ■rt,.r,3 , moae with approved CM61
• vvniten coulorror..otharizal�an -[108 obi-ined 1506 a b-kg-iemrg any � nfore ae„ add-ilicnal ore tended .vrk.
• AMY CEA1175 FOR %uNSTRUCTIDN MEFRUiS ARE SUMEUi 1u TRE NOTICE AMD CARE PR'UVISfvNS OF CHArme-R 559,
FLORIDA STATUTtiS
- BUYER'S R11GWr TO G4NCE1: Thls Is a name aolicltatfon sofa, and if you do not -...t .he goods uir _onicesr you may eo.,cef
this agreement 6y p,,,;lding written netl� 1., the seher In parson, by telegram, or by mah. r nl_ natio must indicate that you
do not want tna goods or services -nd ,,,List be delivered or postmarlMd before mldnigRt of the third busines- d -y after you
sign tnls ograo.,,ent If you Cancel this agreement, tFie Helfer may nest Ramp all or part er -my casR sown p„ymo„t ase the
reve-or Jde hereof for a- w -P11- ation of thL .lg1rL
• I .cknorvledge tRat my Auht .v cancel Ras been c;;pfained 10 me emlly and ;n writing, and withwuT waiving my ---hl w cancel r autReriec IFio
perfvrr„ance of the aeric, aabjecl to all le., and. onlions -1 forth u„ the revema vide hereof, plus any t o upon compfche
KcNotlee To Owner - Do net ..ign ;his home impre7amom contract ;n 51_k. You are entitled to u copy of the ceRlmct a1 ;he time you ..ign.
Kecp ;, ;v protect y�er Iv I rights. This herav im
could r lOct Yo I on if you do .,et P--7-`Trent eontm.t rR.y contain a mcrtgago wr otherwise ere„ to - lien on your preporty
p y. fav sure you u-derel-rid "i provision- of the c ntraet befe,e we „vn.
GATE C"DVIPA 7101 PR
2N ATIYE
-5,,W-MER SIGNATURE
o„T�
Y
"2417 A - x'= .,eeie.,.,Iiai Smv;cee LLC...` rigllle reserved. BATE
'nS307a 0605:7
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A "IMF
Certificate of Product Ratiggs
AHRI Certified Reference Number: rzi:50ag.s Elate: ar a3tAl I r
Product: single -Package Airzconaitioner. Air--uoolea
M.aal RelriBar: bO`PCOJ6---JO"
Manufacturer: CARRIER AIR CONDITI.,NIRu
I roae/Bronx name: CARRIER
Region: All k -AR, AE, AR, Ac,, CA, CC, C I, DC, DC, EE, GA, Mi, in, IE, IA, Irv, ns, RT. ER, RIA, Mu, ME-
MlRIR. R10, RIS. Mi. RC. NO. ME. MN. RJ. RIM. RV- RT. OR; OR. OR; PA; RI; aC, bO, IN, ix,
UT, VA, VT. WA, WV; WI, WY,UA.U. Territories)
Region More: Central air conahloners manuracturea prior To January -i, AO -i5, are ellglole To Be
Inat..11ea in Wli melons a. -rill Jena JO. zOio. Be -incl July 1, z016, central air conditioners
can only be installed in region(s) for which they meet the regional efficiency requirement.
series name:
Manuracturer responsiBle Tor TRe rating of TMs system comMination is CARRIER AIR CORM I IORIRG
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 raiing accuracy by ARRI-sponsored, Inaepenaent, TRIM
party testing:
Cooling Capacity (Btuh); 35000
EER rating (Cooliny): 11.00
SEER Rating (Cooling)_ 14.00
IEER R -tiny (t.:ooiingy
` rsdringb raaiowda By do anrdri k ;-; inuicain d voluntary rerate or previously published dataunless accompanied vnlh a WAS which indicates an nvoluntary rerato
DIscERIMER
AHRI d.— nvt.nd.po. th. predeac(,) listed va ;his C.rrlfiv. lv _nd makas no rvpra n:..;Iurm-..rr4.n:lux ar ga.re,,:eea aq.., .nd ossa ... cm .r,., r-pon3l.1mity iv._
the product($) listed on this Certificate. AHRI expressly disclaims all liability for damag-e of any k_nd a:iel=g out of th- a=. ■p p-rf■prnrna• of th. prodo.t(=), ■p th.
on"ot—ri— .h.r :Ian yr a.ru 1137.. an .RFs c.r:L'i...:a, cardrica radngs are v.lia only ror moucis .na conrigar.�livnlfl
s lisiau In a
dir_.tepy �t - _.hpidlp■■tep;,_pg.
TERMS AND CONDITIONS
This Certificate and Its contents a_e ppopd_taq pwde_ts .f AHRI. Thte C.rtlflwrt. _tell .piI be used f.p lndldde_l, p.rwnal and
cvnr..ential rorumnca purposes. r nv connis or lRls cvrcincnlo may nutin whole or in part. Be reproduced; copied; disseminated; .
entered into ..spripater d..t_b_=e; or atheri plze etillzed, In -my f.rm .p nr.ner Of by »try means, veep: for :hc asci a indF:lda.lr
personal and confidential reference. AI111140NDITIONING, HEATING,
CERTIFICATE VERIFICATION .- In.......r.
The information far the model cited on this certficale can be 4er,fied at www.aht4directory.org. click on 'Verify Certificate' link
wnd .n:.r :he AHRI C.r:lfied R.faranaz Number ana iN. dl. _n whicri mc c.rr.ac... was Iseeoa,
which Is listed abo-e, and th■ Certificate No., -hioh le ILIA _t botl_nr right.
Tuzu14 rail:;Conaidoning, Reaung, anti Rerrigeradon Institute CERTIFICATE NO.: 13151]2434350399181