HomeMy WebLinkAboutBuilding Permit ApplicationHCC HPP[iiWLE INFU MIM) i BE CUDITIPCE i ED FUR APPCI[R i [rim t U BE HCCEP t ED
Date: f Permit Number:
-
Bunaing Permit Application
manning anv oeveropment zervices
auiming anu Coae neguiation uivision
c.1Ou Virginia Avenue, Fort vierce Fi..ywysc
Phone: Fax:(iic)wec-.Loia Cojiimercial Rcsiaenddl
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
'PROPOSED IMPROVEMENT LOCATION:
Piaoress:
Legal Description:'�S-r`LC
Property Tax ID #: ' - _ Lot NO.
!)itc Plan nF.Me. Block No.
PFvJ,eci IQaRIc. S
Front t .J- Ri&fit Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with 0 ton, dl SEER, 5 KW AC on;t
C:UNS I ROTI IUN INFORMATION:
A(Ulmom.1--ark to o,,,,c
under ts -check a
RVHC G_ la..k�permitns Mutters QWindows/Doars
11 Electric LJPlaRl5ing ❑by,;nklers OGenerator
F7 Roof Roof pitch
101-1 Jy. FT. oT C4n31, action:
Sq. Ft. of First Floor: _
Cos. of Construction: 5 15Lilides:zewer 1:1:�epdc
uwNtRj1E55EE:
Dame
tb�s 'a.
Code:Jp N9&j-4
PRome Ii
Fill in fee simple Tide Holder on ne,Lt page ( if different
from the Owner listed aBove)
CONTRACTOR:
Name: Dennis Zacek
Builaing ReigRt:
Company: ARS American Residential Services
Address: 2800 US Hwy 1
City: Vero Beach State: FL
Zip Code: 32960 Fax:
Phone No, 772 794-72
rcm
State or County License: CMC1249753
li Value OT construction Is $c50Q er nwrc, ;-. RECURDED Notize of Commencement is required.
SUPPLEMEN IAL CONSTRUCTION LIEN LAW INFORMATION:
DEaIGMER/ErvGIMEER: x idol /Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
/Address:
/Address:
City: State:
City: SLate:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONMNG COMPANY: x Mot Applicable
Name:
Name:
AddrEss:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
1 certify that no worn or installation Ras commences prior to Me issuance or a permit.
St. facie Coant .F.Rc3 nu rcj,rc�c,.tat6m Mat i� graritiri6 a perm,t rr�h u4tRVri.0 the4 Crmit nolae- [V Saila tFie �a5;.rt 3tractarc
wAicR is in conflict with any applicaBle Rome uwners rtssociation rules, Bylaws or and covenants that may restritT or pronl0k sucn
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of ON requested perm;t, I ao nerc5y asrC. treat I .ill, In all oc3pccts, perfform the 7—rk
in accordance with the approved plans, the Florida Building Zodes and 3L. Lucie County Rmendments.
i Re roiiowing Buil'aing permit applications are exempt From unEergoing a Full concurrency review: room au'uitlons,
accessomyy structures, swimming pools, fences, walls, signs, screen rooms andaccessory o3cs to onuth=. nun -resident -1c1 a.=
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro.ements to your property. A Notice or Commencement must Be recoroen anil posted on the joi5site
before the first inspeuion. If you intend Lo obtain financing, conbulL with lender or an attorney before
commEnLing work or recording your Notice of Commencement.
_ signature of O ,er/ eessee/went
STATE OF FLORIDA
[00141 T rjF %1.7.4
I Mc r r6oimg instrernent -as acitno :IeugeB oeiore me
this Lt 'uay of( (b —Z5Lby
pinio Za—k
15,nat
erson a a d iri6 }
of NZa ub -State of Florida }
rersonally Rnown x OR Produced identification
IyPC vtIacntitiCud.. NrVaaCeil
Commission No.(�(-ti 1S(Seal)
�Ignature or Contra( r/Elcense Ralaer
STATE OF FLORIDA
CvGla I T OF St Lucie
I Fie tarcuirig imtre.merit ..s ,..-Rriawlea6Ca SutarC me
this day of CCkC)P�zvy by
Dennis Zacek
Ume erson ac' rowleB
(Sigr,aeer� oa: to nL31i�-State or FloriBa j
Perianally KMarrri x OR Prudv'.d Iacritit;Catiori
type or Mentirication ProBuceB
Com i„ioriNo, ,e-q�CIYD Steal)
+L; tiuLC:CIy aui.t.FVFtn COLEI~N SULLIVAN
KCV;;ed u/I I `c My COMMISSION u GG071535
••I S Febiva 09, 2021 My COMMISSION # GG071535
EXP
i,•Yp`}�- Gnr,��
r
REVIEWS
SUPERVISOR
PLANS
VEGET
ANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
M., .n it vrvrk. MaRi�p i! n8h!`
mirm-&P
.' bz,, -� yyd ,mss
hizFfa►►atiati Work Order
(7 72) 53r-31 VV
2800 US High -..y 1, Voro Beach, FL. 2960
..merkw Rosidentiat Sewrw, of %rido Inu
Ueen..., w e ... 07Z,34J- tmaa,587B, CFC1428283
Est. Start Date L011's liz
Est Complel r Data 0/1
WIF
Corporate Coelomer
Relatiw
j8661 8030879
F.AI.-SUP
SIZE TYPE -, � SIZE Z TYPE SIZE TYPE
EFFICIENCY EFFICIENCY Y
EFFICIENCY
5UBtuTA
TTH YLEST ` $ / S— I MONTH YL 5T" MONTHLYL
MON
CUSTOMER INITIALS I CUS7t7PlER INITIALS
Warran,y: ; Parts �� LaBar W r O
an,y: Parts , Labe.
�a_Con+prtsaae 1_�J HnatExchanger O Vora resod,
P JO He., Exchanger
tU.,lass otherwise noted, all from .he rrra„ufacturer.
'0 Wv.ifitr root_ i10 Na- Plywa d Dack
Diec..n..acc /y
gLifelime EquipRlant Slob
1 Ra..onnuct Drain Line
Ceiling 5a-=; Kit
OSe3nd laelalion Pads an & Flwoq
F Liquid Tile Vondu.t
Drain Sarely Switch
0 St -rt Kit
9(JSea: New Cmurf—atiarl..
AfR4f..garant LL Dryer_
ft7Sepport Aaic Equipmcnt
�R rigerant Pape
ft3 Supply Plenum
New ❑ Reev :nvc:
15 New A Recs.,n.el
efrigeranl Pipe Cover
J'I Retarn Plane...
Expansion V Ice
❑ Nae JZI Racun,.ect
J11%tm-Type
❑ Electronic Air Cleaner
.L.i Connect to Existing
15 Media Filler
Electrical
p Puz
❑ UV Lighi
❑ Humidifier
❑ Dehumidifier
0 Outdoor Ur1:t Pad
❑ Flue Venting
I,,�Ductwork VennecG_rlc"
ja'Conneo: to erring pienum
Deet ModiGeetions
:eery Tlrfes for scope o1 wvr�J
❑ Mew Muct 3,st....
U No Dow .,cork
❑ Foul r.ping
q E.octrical Wiring
X(Home aerv'ce Plan -
1 Term (364 davz]
0 Comfort Guarantee OHvinv Pretvcti.,n Guarantee
JZ24-Hour Serrcc. Gear,vnlea W; 00% Unconditional Moni,y-Back Gs.....nlao
/ $ 7, fzs-
3T. ` $
INITIALS
,f-n:y:r Paris ____�_ Labs,
—C.rRpresce- H—t Exc„anger
SELECTED UPTiON (rt 02 09
SUBTOT-1.
/'2- — '
TOTAL d T�
o CASH ❑ CHECK#
❑ CR.DIT CARD BLAST 4#0l
EXP APPROVAL
❑FINANCINu i r
. oyment opliorb available wah approved uredo,
/�/�✓� CPIJC�.-510. �p JPS/� 7irata �Y'����- r�
/9P eV
",MS is not responsible for prea..i„ ting do., ryork. Soe Terms and i..On iti_rlo an the b.,ek of ,h .• doco,„ent or dotal s.
• ...,.run customer auth.w_.ti.n -ill by obtained bafvr. 17eginning any unf■r._c.ri addBram-I ..r a.rendou work. T- yz.-....- G7 A i
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUB.ECT TO THE NOTICE AND CURE PROViS�0175 OF CHAPTER 558,
FLORIDA STATU � ES.
• BUYERIS RIGHT7aCXNCEL: This Is a ham. �liaitgtivn ale, wno F you do not want the awd= vr..o. Ices, you may cancel
this ag!lemant by prb.lding written notice to the sslir I;; pa...v.-y by -seiagr am, or by mail. This ..,ti=e ...erst I..dim.e t.rat you
do not want tna gaaTB or ,apices and must oe dellveretl or: pestm:.r cue before mluntgllt of the tRlra 3rroinoaa day after you
sign tnis ..g --anlanL If you cancel tnis agreement; tRa ..eliar May not keep all or part of an,- wavR drn payment see We
rev., -ids h.. . -f for an explanation of this right
• I ark -u --lodge th,.t my, ighi zo ...ncel has been explain=d I. pre ort. ly and in w, wrig and without wai-:.,g Iwy �ghl tv eanve', I ooinunzu the
performaw=■ .f the work, mobjaci io all ta....a and condll ons a=1 f.rth an thv rtrvaeee aide RG. sof. plus any laze= upon eomplellon
Notice wner n a;gn :his home improvement contrail :pi blo..k. Yoe ore arnaled t0 a copy of the contract al the li-a you ergn.
Keep i 0 lest aw c9W ,:ghs. This home Improvement contrast nr..y vent..in a mors r Vu.erWic at= a lien an yoer property
that to cls .,n if y do nal pa'y, Be sur yce e..damtw.,d all provisions f'Ihe co ct rs9fors yes 'gm.
CU len., DATEvinRlnT
13,03=1MER SIGNATURE p)<, tr -- r•
DA
v 2v.5 w,.arican Remdenral services LLG -.r ngria reeerveo. nRS1078
e=ae
Certificate of Product Ratings
AMRI Certinel7 Reraronea nam6er : 9764468 Date; i0-iz-z018 Mo'uel Status : Active
ARRi I yya ; RCU-A-CB
Series : C.'vmpor% I 14 AC
vutaoor Unit Srarli9 R�rno: CARRIER
uetaoor Unit Model NumOer tCon0enser or 51ny10 t'oeR�ua) : Z4ACC424rt"`tNu•
Indoor unit 1010081 rvum0er (E-.-porater �mdlov Air Handler): FR4CMFOc4L
Region ; 5oelFica3t and North %'PtF-, AR, DC, DL, FC, GA, RI, lKy, [A. IGIO, MS, NC, Un, 3%, 119, 1 A, vA, AK, Cu, it 1, 10, IC,
]A, Iim. R5, MIA, ME. Nil, MN. MO. MT. RD. NE, MM, Ma, IST, UM, 0K. PA, RI, 50, 0 t-, VT, WA, WV, VVI, YY T, u,S.
I arrit—;u,3 )
Region l4otu : Central air conditioners manuiacture0 prior To uane,r 1. 2015 are eligi0le to 0e Installe0 in all. viiam3
until June 3U, z016. 6es;n.,in-y Jaly 1. 201U ceniral air conaitione.- van only 6W Installed in reyionisl For
which they meet the regional emcieneT .o,,eiro,,,e.-,t.
I Ro ...-.matoetaror of this CARRIER prtiauta Is responsil56 Tor tf-ta .sting of this system comBination.
Rates as Tellarr m in aecordan-.e with the latest e5luon 01 AR54ARRI ?10!240 —filth Addenda 1 an'u z, Performance R_dno at Unita,—'
Air-Condiuoniny 3 mir-Source Meat ramp Eyziprnant and subject' 'to raiing accuracy 0y AAAI-spenza_d, indel.-ndent, tRIM party iesling-
Coolingg Capacity (Az) - simule or High Stage (ozjF), 0tun : z4'ov0
sEER:t4A0
EER (A2) - Bingle or Mlgn stage (aoF) : 11.50
t"Acd.a" Model Status are those that .n AHRI Certification Program rerdGipant is currently produsin' AND oalllng or off ri„ g ro, sale, OR new models that are being
Iriarkatcd but ere not yet aemg produced'Production Steeped" Model Stotos are u,uao that an AHRI Certification Pmgmm P„rtieipo,,; is ri . longer producing BUT is still
selling .r eHaring fee �.le.
R-1ir., x'h tare =ecru read b WAS ,rdicaie , n i nvoluntard re -roti The new put,lished rat'nq is shnvrnv alor: with the p re -iris j i.e. WAS roling
.
E13vLAIMPR
AHRI do=s not e, -gorse the producrtsl listed ■n thle Certifla-te .end maRes no representatlons, warrattllee OF geor�.ntuas .a to, a„a ■.somes no responsibility for,
the product(s) Ils.ad on .no Certificate. AHRI expressly dkel..lwrz 011 liability for demegus or any kind arising out of the e7a OF performanca of the productgs). or the
unauth■.1-ed alteretlan of d..x. Ils:=a on tills Certificate. Certified ratings are -olid e„ ly for medals an.r configurations listed In th=
directory at www.ahrldl.-e=t■r;.erg.
TERMS AND COND17luM.
This Certifleota and Its eomarim arc proprietary products of AHRI. Thlc Cerlilleota sh..lf only Sa risco .or individual, personal and
confidential refe-en_e =rpsoe,. Thu e.ntenz3 o, alis Certificate may not. In whol■ ■r in tort, be rop-docan; , upied; dissemiMR!
nated;
per. -...nal nd t:ormuentlal reference.
=niereo into a computer database; .r ■therwha wtlll.ed, in any germ or manner or by any me.na, e..eapt fur the osar's rnui�idual,
eAIR �enenlen111a, HEATINO,
CERTIFICATE VERIFICATION & REFRIOER„ .on
,.,e inrormation for the model sited en thlu eertlflu..te c.,, Ea .trifled at www.ahridlre=t=i; .■rg, click en'Vo-Ify Cara l-te' link
..nd enter ,,,u . RRI Certified Reference Nobe; sad lh= datu on RRlcn ma cartiflcate was Issued, �- -..Le lifa I :r:.r-
:hieh b liztad .-bo:e, ens tr,c ecrtificate No., which Is 11_t_d at bottom right. r" _
02018Air-Conditioning, Heating, anti RetrigarAun Institute I [:EK i WICATE NO.: 131838212230317822