HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
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^
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Add, ess: 195 SERENATA CT PORT ST LUCIE FL 34983
Legal Description: RIVER PARK UNIT 5 BLK 46 LOT 33
Property Tax ID ##. 3419-540-0137-000-3 Lot No. 33
Site Plan Name: Block No. 46
Project Name: RODWAY AC CHANGE
Setbacks Front Back: Right Side: Left Side:
DETi-flLED DESCRIPTION OF WORK:
AC CHANGE NO DUCT WORK CARRIER 15 SEER 23400 BTUH SPLIT UNIT
24ACC6211A FB4CNF030L
� C 111.. 111,0;011
INFORMATION:
Name ALPHANSO RODWAY
Name: DENNIS ZACEK
daition—vork to e e orme under tis permit —checka
OHVAC 1, Gas Tank ❑Gas Piping
11 Elect-ic 0 Plumbing []Sprinklers
appy:
_ Shutters
O Generator
Windows/Doors
Roof Roof pitch
Total Sq Ft of Construction: _
Cost of Con_truction: $ 7650.00
S . Ft. of First Floor:
Utilities Sewer [] Septic Building Height:
OWI , ERAESSEE:
CONTRACTOR:
Name ALPHANSO RODWAY
Name: DENNIS ZACEK
Address: 195 SERATA C'
Company: ARS
C ty: PORT S F LUCIE State: FL
Address: 2800 US HWY 1
Zip Code: 34983 Fax:
City: VERO BEACH State: FL
P one No. 56'-329-5838
Zip Code: 32960 Fax:
E -Mail: TDABERKO@ARS.COM
Phone No. 772-795-7221
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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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name.ALP14ANSOROOwAY
^
Name: DENNIS ZACEK
Address: 195 SERENATA CT PORT ST LUCIE FL 34983
Address: 195 SERATA CT
City: POR- ST LUCIE State:
City: VER° BEACH State:
Zip: Phone
Zip: Phone:
EE SIMPLE TITLL HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 2800, S HWY 1
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ertify that no work or installation has commenced prior to the issuance of a permit.
St Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
w -ich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
st ucture. 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,
ac, essory structures, swimmi-7g pools, -ences, 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
commenci:i�, work or.recordinrlyour Notice of Commencement.
Signature cf Owner/ 'Contactor as Agent for Owner Signature of Contract (cense Holder
STATE OF FLORIDA STATE OF FLORA
COUNTY OI 10t1c_ cam;✓/� COUNTY OF
The forgoing instrument acknowledged before me The forgoing instrument was acknowledged before me
this C day of _126L2by this Z day of OC'r-�_ 20 by
. r l s GIS k- DENAI15 0A C,_ r
Name of p rson making statement Name of person making statement
Known OR Produced Identification Personally Known,} OR Produced Identification
TyFfe of Id
Pr ducad _ Produced
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15irnature of Notary Public- State of Florida } (Signiiture of Notary Public- State of Florida }
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Commission No. 7 (Sear „nAR,'YPLIL+LIC commission No. .trA- [ "fHW"'(5�a1)'�t:�'ItCz
t ST ATE Q= FLS}lit . NOiAF;Y PUBLIC
t�STATE CI FLOR€.
REVIEWS FRONT ZONING S10EAV(SOR PLANS VEGETATION SEA TI[fiTL"E&r INAIjiGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
C_OMPLET_EO__
Rev. 8/2/17
A , 0011%La aL
Hosting' plumbing
Est. Start Date
oInstallation Work Orders EstX0,2
. Completion Date ��tz
1AV-\AC5
(772) 567-3100 Corporate Customer
2800 US Highway 1, Vero Beach, FL 32960 Relations
AmerKan ResrdentW Smites of Fiord$ Inc License / CMC 11249753, CAC04WR CFC1428283 (866) 803.0879
EMAIL CALLSUP
CUSTOMER S n
ADOREss
F CIiYISTATEI2 TI /f i
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HOMEPHONE
CELL P.O
WORKPH0NE
YOUR HVAC SYSTEM DESIGN
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SIZE ,Z.. s_ TYPE CRC6 6'
SIZE TYPE
SIZE TYPE,
EFFICIENCY LW- 5CG
EFFICIENCY
EFFICIENCY -. .
$ OD
$
$�
$
�n n"
$
SUBTOTAL $ A
SUBTOTAL $
SUBTOTAL $ _
MONTHLY EST.' $
MONTHLY EST.- $
MONTHLY EST.' $ o-
CUSTOMER INITIALS
CUSTOMER INITIALS
CUSTOMER INITIALS
Warranty: 1110 Parts Labor
Warranty: Parts _ _ Labor
Warranty: Paris Labor
—W—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 • +
SELECTED OPTION: ❑ 1 ❑ 2 ❑ 3
❑ Weatherproof 13 Connect to Existing ❑ Electronic Air Cle r
f�lectrical
SUBTOTAL $ � t Roo
Disconnect ❑ Media FI ter
Lifetime Equipment Slab ew Plywood Deck ❑ PCO
t r � D �!.$
�Scund iso ation Pads Reconnect Drain Line ❑ UV L' I
$
❑ Liquid Tile Conduit ❑ Ceiling Saver Kit ❑ H difier
(Pan & Float)
`
TOTAL $
❑ Start Kit ❑ ehumidifier
in Drain Safety Switch
Refrigerant LL Dryer Outdoor Unit Pad
Refrigera t Pipe sal New Connections ❑ 1= tie Venting
• `
❑ New I�Reconnect ❑ Support Attic Equipment Ductwork Connections
W❑ CHECK#❑
Refrigerant Pipe Cover ]Supply Plenum ❑ Fue' Piping
'`❑ NewI ReconnectElectnca!
;CCAS
�t� CC
❑ Expans;on Valve Wiring
Al etumPlenum r$HomeService Plan—$'�a.
RED17 CARD (LAST4#s)
IP, New Reconnect T`1
Term (364 days)
EXP APPROVAL,____._
OUR GUARANTEES
FX Comfort Guarantee KlHome Protection Guarantee
❑ FINANCING' .
4•Hour Service Guarantee 100% Unconditional Money -Back Guarantee
•Payment options available with approved : redit
NOTES
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• Written customer authorization will be obtained before beginning any unforeseen additional or extended woX a4 r'[7on
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROVISIONS OF CFiPOTrF�! 858,
FLORIDA STATUTES, �/{�(�`6'
• 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 rlghL
• I acknowledge that my right to cancel has been explained to me orally and in writing, and without waiving my right to cancel, I authorize the
performance of the work, subject to a' terms and conditions set forth on the reverse side hereof, plus any taxes upon complel on,
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 rghts. This home improvement contract may contain a mortgage or otherwise create a Igen on your property
that cou d be foreclosed on if you do not pay. Be sure you understand all provisions of thcontract before you sign
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CUSTOMER ATURE DA CO PANYR ESEMTArve
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CUSTOMER SIGNATURE DATE ICAI DATE
C 2017 American Raremial SaMces LLC. AN Mh1s msam L APr.1079 C 5C 817 (• L l Y / {„/� 6256
CERTIFIEr
Certificate of Product Ratings
AHRI Certified Reference Number: 9178277 Date: 10/23/2017
Product: Split System: Air-Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 24ACC624A*0304
Indoor Unit Model Number: FB4CNF030L
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 name: PERFORMANCE 16 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): 23400
EER Rating (Cooling): 12,50
SEER Rating (Cooling): 15.00
IEER Rating (Cooling):
' Ratings followed by an asterisk (') indicate a voluntary rerato of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate
DISCLAIMER
AHRI does not endorse the product(s) listed an 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.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 AR
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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.ahridirectory.org. click on 'Verify Certificate" link „ r aka ill ksurate,
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. -
02014 Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: �31532340fi580ssf37