HomeMy WebLinkAboutBuilding Permit ApplicationmLL A%PPLICABEE 1111`0 101x3 i es: COMPEETEG Pvl! mPPEIMv Iola 1 v BE hCCEP i E13
Cl-tc: _`�Ikg n Pcr.,,it lQanil3er:
s
Building Permit Application
Planning and aevelopment services
nuilding and Code rreyulation Division
za u virpyinia Avenue, Tort Tierce rt 3w�-az
Phone: (772) 462-1553 Fax: (772) 462-1578 CuPllmcrCial RC7iftntial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lima
PROPOSED IMPROVEMENT 10CATION:
Address: Cti
Cvgal Cio,,eriprvn:�ZpP1lS �S�VC • i1Cl:�r i •`F,�1C �� l.,a� ��, _
Properi, i a,. III;;: 1 Lot No.���
-)ite Plan flame:
Project Name:
:,edlacRs Front BaCR: RigRt title: Cert .Ji0e.
DETAILED DESCRIP I IUN OF WURR:
Replace AC, exalt change out with 5 on, 16 SEER, 2� KW AC Unit
Block No. t LA
Cu195TRUt-11019 MFORI01AlION:
Additional work to e e Orme un er t is permi_app y:
OFivw% Gas Piping
Gas ianR ❑Windows/Doors�0�
Electric M PlumBing E]zoprinRiers 11 uene.-.tvr � Roof Rovt pii.Fi
i oral >q. Ft of Construction: SFt. of Hr,tl Floor:
Cost of Construction: 5.1m�s-fib Udlides:'n
Sewer LJSeptic Building nelght:
uvvIQER/1_E55EE:
CU19 I RAC:I UR:
Mame Eve-\ T-iKe ri-,
l9ame: Dennis Zacek
Haaress: ali, Ir, nCi-&-kowl
Company: ARS American Residential Services
City: C bale: E,
Address: z300 05 Rwy
Zip Code: Fax: r—
City: vero SeacR FC
PRone IQo.
[ip Coo.: 32960 _ Fax:
t-101ail:
Phone No. 772 794 -72 -Vi
E-Mail:�SU��t.�wa, G.(5,;,Ccm
Fill In fee simple Title Holder on next pave I if differen.
from %he Owner listed above)
state or County [icenze: CMC1249753
If value or construction Is SzAG or more, a REGORGED Notices or Cennncric merit i; reyeire7.
5UPPLEPIENTAL CONSTRUCTION LIEN LAW INFORMATION:
QEaIGRt:R/EMl3IivEER: x Mot applicaBle
IQIOR I SKt3E C URRPAM T: - Mot applicable
flame:
Mame:
address:
address:
City: estate:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Nut Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
AddrE33:
Address:
City:
City:
Zip: Phone:
Zip: Phune:
I certify tnat no worK or installation Ras commencer prior to the Issuance or a permit.
St. Lucie Count rn.Rc. no reprc3entation Oat is srontIme . j g mit will aatflQrizc tRr rmit nvlacr ty Balia tRc sv5;cct 3truct,.ire
wMicR is in conflict witR anyapplicaBle Rome Owners Association rules, bylaws or and covenants tnat may restrict or proniBit sucR
structure. Please consul► 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 tFiat I will, in all respects, pertorm the Work
in accordance with the approved plans, the Florida Building Codes and 3t. Eucie County mmendments.
Inefollowing Builr3ing permit applications are exempt from undergoing a full concurrency review: room a5tiltions,
accessory structures, swimming pools, fences, walls, sirns, screen rooms and accessom r uses to anothe, 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 M01ke or Commencement must 5e recortaeM anti posieta on ine joEsite
before the first inspection. If you intend to obtain financing. consult with lender or an attorney before
commencing work or recurding your Notice of Commencement.
1 '
_ zignature of O er/ lessee/Rgent
STATE OF FLORIDA
0001111 I T OF 51tud.
I Re fer6v:rl6 i.,st�t�a—�t �• � �^^s:
^^ 'etlgetl Before me
this 1 uay of C't za ]�by
Zank
peraon
signature of Contrad. r/ucense Roliier
STATE OF FLORIDA
n0M I T OF sttj_.
I ne torgoins in3tramcnt ..a. acRna leasea hcfvre Ric
this _a day of C)CAdW zu by
Dennis Za k
(RI e o erson acRno le 'g
gnate�e Ivet a lic- a Floritao )
Personally Rnown x OR Produced Identification Pcronallr Rno..n x UR Proaaeed lacntitiwtio„
I ypc vt Iaent:tic-tiara Prvaacea type oT IQentiilcation ProOuceB
Commission No. (Seal) C.vrmF5i33:en Ivo � t� �7 {�,ealj
MY COMMISSION # GG0T1535MY COM MISSION # GG071535
tceV sed 01! 15/.zc EXPIRES February 09, 2021
EXPIRES February 09. 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MA GROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
MM -king
hlrikln9 i' �OrR
t4fi `lLS 6+q1L'` Est start Date (v $'
_ Installation Work Order
'T id lJv it, i e) 56r-;�i f3D E -t CemplatlaR D, -t- o
2800 US Highway 1, Vero Beach FL 32960 Corporate Customer
e6mri Ravioanlia; Cenicea or MErioo, ;rte. Ralatiams
L.cenae M CMC1249753, CAC045878, CFCs 428283 (666) 803.0.79
CUSTOMER {{ I ERIMIE
llt�
CALL 31-1vr
nupRf:Sa /�,_ _ cl, �•�,n. �. car /
RPRI! FROM
CCLL F'
u -Z -
YOUR HVAC SYSTEM DESIGN
OPTION I
OPTION 2
OPTION
5fZE S t ufJ TYPE i&M�,r�
SIZE I YPE 5;7 �
51zE TYPE
.
E FICIENCY Afi df k -gX.Aj.L—
EFFICIENCY 4 s-rMZ5iK/177..5�?i
EFFICIENCY
H(O-
4 He r— 30 —
$
$
Cp"a5GT711t-'1 C
1 •' y
$
$
$
$
SUBTOTAL $O
SUBTOTAL $ �lLt L!
SUBTOTAL
MONTRLY E5T.' $
MORTRLY EST.' $ " )Z rs
MORTHLY EST.' $
CUS101aIER119IIIALS �
CDSTOMER INITIALS ir1•u (A'
CUSIUMER IRITIALS
W rraniy:t Pans _ [al7vr
Wnn'aniy: _in P.n. Q Labor
Warrnniy;,, „__ . Parts Labor
Camp;anuor . —Huul Exeh-ng.r
JR—Co ... prozi.o. _-LEFjisat Exchanger
_,Compress.r ,.._Huai Excho„gor
Unless otherwise noted, al warranties are from the manufacturer.
SPECIFICS OF • •
SELECTED OPTION: 01 l_I3
vveatllerproo� Me. Plywood Duck 0 t3v Eiglit
DI3ecRRaat
Reconnect Drain Cine ❑
SUBTOTAL $
Vidifiar
ifetrme equipment sla ❑CQIGng Sa.cr Ki; ❑
❑ S.u..d 1�.la;;o.. Pads (Pan & Float) 0 ta0
CiquiM I de C.onlau t P -M -in Drain ti-Wy S -Itch 0
-
❑ Start Kit rkeai Mew vonnections 0 Daetwerk
TOTAL $ �1
Ref- -rt=Rt LLD e- 17 wnnect to existing PMnum
meg.- ry ��'r ❑ Sappor. A:;icz Eytsipmen;
cc
Refriger t Pipe Supply Plenum ❑ Duct ftw 1 -ie pw of
1� N��� I� �� —�
I lew �.$econnecl (�j N.-..
�RaeeReeat ❑ New Duct SysterTtj�\-_p
Rof..garnni Pipe Cover Return Plenum No Do.i Work LIy
❑ CASR ❑CHECK#
❑ E�p_m=len V I:a E] Me- ' Rec.nnv t [34,Fuel Piping
'03 -slat - type c Ar aner❑ Electronic
0 Eleelria-I Wiring
❑ CREDfT CD (CXziT 4#e) _,
Connect to s;in- 0 Mena e _ e Home Susi a Pi.n -
a
❑ f'%:Li
EXP APPROVAE
lectrica! 1 Term {364 days)
•
�.FINANi.INu' � t
Col fon Guarariea H.me Pro;e.;ivn Gnaranieo
/ 4 U, Z£�
24-mour service Guarantee 0% Unconiaitional Rloney SacR Guarantee
-P-,--■t ■Min=i aaable -im _per credit
NOTES
`
gsPrmor,?ay
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rA,�_
r
'ARS is rt.i r—panallato for premia: ng du. .rk Su- Terrrro and vrtdiiivna ." ;he back of W3 doeomani for d ells.
• Wrinen �usicmar nwh.ric ,icrn will be ob;arned before bcgir 1 nny onf.rLseen nddii. m.nl or ax.e nded -work. ( CCS
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROViSIS OF CH ER M58
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
tflis agreement By providing written notice to Ole seller in person, By telegram, or by main. r tris notice must indicate that you
do not want the goows or services anN must Be NellverM or postmarked Before midnight or tine 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 oral y and In writing, and without waiving my rigRt to cancel, I authorize the
peRormance of the worR, sul%ect to all terms ane coned ons set forth on the re -erre s:d= hereof, plus any taxes spun wumpletien.
Notice To Owner - De Rut clgn thin heR+e i�-_pm-.omeat aamlw-A in Block Tac a -e e..litled to - e., , of tMv .entreat at the t;rRe yflc ..inn.
Kemp it Is p. -tout year leg -I Pnht=. Thi= heRra imp, a -;._.e: t went, set m -y aentaln o .,,ertgage e. othemine ere -lo a lien vR year pmper 7
iho..ould b. I_oul.eed on it you d. not poy. Be suru y.o ondars;and all provisions of the oonimGi before you sign.
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d,. c - CaIRR.RT @ e3eR:.,�R!
c' t�'Jys
C 6R'SIGNATURE DATE DATE
v:e: e..aror.can Rmeae.ia Semen LLC All..gllle reeerro.. ..R5:e-! :::e:C arae