HomeMy WebLinkAboutBuilding Permit ApplicationREE mrPEIMBEE UIFO 11`1003 t BE COI—VAXPrED FOR KPFUM i,vty 10 Of mCCEP i ED
Date: I I `t 1 I C� r�rrnit Number:
MA&
Building Permit Applicadon
donning and aevelopment services
uuildiny and Code rieyulorion aivision
z,DG viryinia Avenue, Tort r•ierce rz sN,az ll//
Phone: (772) 462- 553 Fax: (772) 462- 578 Commercial Re�iaential I,,-
PERICII I APPEICA I IuIV Full: To Select from dropbox, click arm., at the -Und uf fine I
I PROP05ED IMPROVEMENT LOCATION: I
e;ddress:
Legal Description: U _ L CAI i;tC 2748 - Q `CQA
Property Ian lu x:69 t(b . `�f - - LOL No.
Block No.
Project Mame: rIL,
z�etOacRs From 6acR: Ri6Rt Siaw: Left Side:
I uE I AILED 6E5LRIP I iuN OF WORK: I
Replace AC, exact change cot with tan, --ILI SEER, KW AC unit
6�j C)c L02Y.--
CUNs i RIJ IUN IM1-ORIVIAI IUN:
Add nional work toe ne rtorme an e, t i, per...it-check all apply:
1.1RvAr- 0Gas i anR ❑Gas P;ping _ Shutters Q Windows/ Doors
13 Elel:iric U Flumlling ��prinREvr� � Generator � Roof Roof aitch
Iota] -Jq. Ft or Construction: 5 Ft. of First Floor:
Cost of Construction: $ Utilides:DSewer ElsepLic 6ui;aing Fleignt:
UwIQER E55EE: CUNTRACTOR:
,vame Iqa„—ie; Dennis ZaceK
Adare.»: TAI Company: ARS r,merican Resiuuemiai services
City:1L.V.
Skate: E.•
Zip Code: Fax: ---�
PRone Mo.
E-Ivliil:
Fill in fee simple Title Holder on nem rase ( if different
from Che Owner lined above)
mddress: zBOv vs Rwy -1
city: veru 13W.Un State: FL
Zip Code: 32960 , Fax:
Phone No. r rc ryy-r�Pv
E -Mail: c 5v
Mate er Caa;ajr Eicense: CMC1249753
IT value or consrruction is $z30'u or more, a nECUKDEU watiee ar Com eeecment treywirea.
SUPPEEIMtN I HC LUMS I RUL I IUR CIEIq MVV IMFUKRIA I IUM:
Name:
Add re>>
City: _
Zip:
ehone:
Not Aliplica
State:
FEE SIMPLE TITLE HOLDER: = Not Applicable
Marne:
mddress•
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Cirv:
cip: Phone:
X Not Applicable
State:
BONDING COMPANY: NOLApplicable
Dame:
madress•
City:
cip: Phone:
I certify that no wo. R or ii-.stallation Ros commencei3 prior to t9r- i..aarrce or a permit.
St. rucie Count makes no representation that is granting a permit will authorize rhe ermit Molder to T=ruing tyre sullject structure
which is in conflict with any. applicable Home Or...ers As3orria;on rales, byl—s vi no covenants that may restrict or prohibit such
stricture. Please consun wan your Rome owners Association ans review your Qeeb for any restrictlons -nidi may appi,
in consi"aeration of tRe granting of tlirs requestea permit, I 'ao neredy agree tflat I will, in all respells, perform tMe worn
i...,caraamcc.itn tMc..pp,v:za pi -i-,3, tiic rariao Caac.-i-A X. Caaic CveruE, Amc,.amc..t:i.
The following building permit applivatio,.s arc cncn.pt trom anacrg-ing a tall cvncarrcncr re -;;.vv: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms ana accessory uses to anotfler non-resisentiai use
vtrAHM1111r7 113 0vvMEK: your failure to Recore a Notice of Commencement may result in your paying twrcc To.
improvements to your property. A NuticE of Commencement must be recorded and posted on the jobsir.e
before the first inspection. If you intend to obtain financins, consult with lender or an attorney before
commencing work or recordingyour IQotice of Cvinmeneement.
�Q
QJ~ -A s
_ birmatere or C er/ Cessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF --
The forgoing instrument was acknowledsed before me
tbi, i a., yr 3C1l1rtlart . , Al Lo,
as nim w c�
(N e o Verson a le - g }
gnaiure or Aot E - tate or rloriEa I
Pcr.enall, lino -n x Crt Pros=eca Iac.,Eifical.arr
Pype of Identification Produced
Commission Iqo.
COLEEN SULLIVAN
Revised 07/I5/2br054r- - EXPIRES February 08, 2021
STATE OF FLORIDA
COUNTY OF 61Waa
The forgoing instrument was acknowledged before me
this S day of sjd4 UCsi'L.! 20 jA by
Dennis Zooek
(Na a of erson ackri dgigIA
gni r of No u lic- 0TWWOlorlda }
Personally known x OR Produced Identification
Type of Identification Produced
Commission No. t-4 01 (Seal}
My COMMISSION # GG071535
EXPIRES February 08, 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Certificate of Product Ratinas
AFIRI Cvrlmoa Rotoranrse NemBor : 1490503 Data : 01-08-2019 vmouel atalus : Fictive
PtRRI type: aP-Pt
Series : R4 l'uA AC 5PP
Outdoor Unit Brand N..mo : CARRIER
Cut-uoor unit ICloeel MumBer ZConBenser or Single F;acRage) : 50z:PC533---30"
Region : All (AR, Ai, AR, Ac, CA, U0, C I, UU, DE, FC, GA, RI, 10, IE, IA, IN, R5, KY, EA, RIA, MD, ME, MI, MN, MO_ M5,
MT, NC, MD. A;=, AR, Ido, MM, mv, rvr, "R, OR, UrK. PA, RI, 5G, SQ, I M, IA, 0 r, VA, v 1, YYA, YYv, vvl, vvr, 0.5.
I erritorlou)
Re-WiRn Mule: Control air oenaFtiorlers nl�netuotered p,-iorto Janoa-r 1, 2015 are cliyibte t� be installed in all regions
until oune 3V,015. Beginning zjuly I, cti Io cenTral air con'aitioners can only Be installe0 :n —=ion(=) tar
:moll tRoy Moot tHo rayioRal otticloRcr I'ayei, rnvnt.
I Rc rn..rletaeter�r of this CARRIER proaeot i.. rcaponsi6lo for tho rating of this system combination.
Raletl as Tolle-: in . eeertlRr,oc :itR tfle lot.=t edition vl ANSIlARRI 2101140 MOM Addondc, 1 and 2, Performance Rating of Unitary
Air -Conditioning & Pslr-source Meat rump lyuipmem an'u suBject to rating accuracy By mMRI-sponsored, inaepentlenl, tRirt7 party tozvni:
Looiing Capacity (r z) - single or Rigg stage (=F), BteR : 3tiv00
SEtR : 14.00
EER (A2) - Single or High Stage taolsl . t ,,bu
T"Active' Model Status are those that an AHRI C=ruff whin Prosralw Perdwipant is earro-fly prodeeirrg AND selling or affc.:ng for sale; OR ne- medols that a, being
marketed but are not yet being produced'Production Stopped' Model Status are those that an AHRI Certircati_n P—ensm Portieipopll ie no longer predaeing BUT iz Mill
se11i..g or offering for sale.
Ratings mat areec[oTl�3iifav Dv .:.,� indk;ulu an in-oclun'...arfr r@-r2te. The now u4blished raUng is shown alr�n with the ma-ious fi.a. WASI rating,
DISCLAIMER
AHRI does not endorse the productfsl listed on this Certificate 5nd make: — r_pre-ntAlsn:... �rtentiem or geopowtee- -a to, ,.nd-zztrrnc� ..-.o .—pensibilty for,
ino proaoc.isr listaa on tnis Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the esa v perfe.manec of th= ppadzet(,), or the
er,,.e:herl.cd altcraaon of dots li-.00 on :RIs Gcrrlrtc.Z-. ecrtl,.ed rmInip at. OdhV Vnly tnr models and configurations listed In the
disatari of—.ahridlraatar7.erg.
TE..1117� ..ND wNDITIONS
This Certifi—ic, o..d is oracn= a.c propriclary ph,aacts yr .,RRL ...ds eert,rluate shall only be used for Individual, personal and
eanfidentiol refe:enee perpe..es. The eont.rits cf We Ccrtific...a m -.y no'.. In whcic or In pari cc rwpro..acca; [;.,pica; visscminated;
entered into a computep databa_a; up athc."-1-■ still -ad, In -F17 fawn or R.Qener or by any ...eons, w—upt for Lha »ac.'s Indl:idouL 1111
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The Infoppe ati.n fop the mwd_I cited on thi: rrtlfiaete can be .eplficd at--.ahrldircotory.arg, lick an "Verify Ca. -.lose..' lintll t,c tram iin Metier -
and enter the AHRI Certified Reference Number and the date on which the captlfical■-a:l-s=■d,
srIll— Is IWco ueuve, no me ccrtificale No., which Is listed at bottom right.
02019A1r-Condidonin& Hearing, an'u Refrigeration Instlywe M uER 1 IFR ATE NO.: 131914216006273057
tl"J ►rtrar`attiWar, r
, work Orde• "ry �� Start °�t� `�$
A �`%%LJ �0/'3 1 UV . ■ y Est. Complai,on Date JQ �
. iris 2800 U5 FlitiR ay 1, Vary Reach, FE .2960 %,orporate Cust_ er
fvt�kin9 ; ht
meld.gir-• L.cen--Arner* CMC124B 53 eCAC04b878. CFC1428283 i866e803 OB79
CUSTOMER ^� zRllS!!
CALLS'! P
ADDRESS,,,n
•
HOMEPHONE
CELLP N -ORR!•maRp
YOUR DESIGN
OPTION 1
OPTION
OPTION 3
Sir -I! ! , PE
51cE �,� I TPE
SIZE TYPE
EFFICIENvr
EFFICIEM T L vr�� _
EFFICIENCY
$
c.��l AGt
$
$ "l Ooo
�C m_z
$
5en; i- `t $
*D Ui�crstrrl�
�! rile -
> (D (Xi jr
J _,rl=`fes
-
5osr%rrAl: (nL ICS -110f).
5U61OIAE $
avGrviAl! $
"IuRTRCy E5T.' y a± law
ParITFICY E51." $
MONTHLY EST • $
C00 -1U IER IAMMES
iA5TOMER 119MAES
COSTOMER INITIALS
Warranty.T Parts EW;!
W,.....-.tV PFrla [a6or
Warranty? Pits caEor
=mpressor Real Eloilanger
1D__t= mpm=w JDJ9A)1eul EzcTia..yer
-.,..._Ca ... pressor ..,Heat O u uer
1U.Jeaa otfiarwise naiva, a•va..a.tive are from the manufacturer.
• • ■
5ECECTED OPTION: ❑ 1 2 ❑3
❑ Waaiflai--~roof p Mew PlywooE 15eCR 15 uv EIgnt
19 sconnect
❑ Ro�a��na�.t D.a-n Line E3Hemilihar
SUBTOTAL $ Wo
�LLtima Eqo pmani 5;a6 ❑ Dehumidifier,
17 Soun5 Isolation Pedes (P�ri & Fioat) 0 vutlloor Unit Pa -5
❑ Ugaid Tote Conduit G I=n Drain Safety 5YMER 0 Rue Venting
43
0 Start Kit ❑ Seal New Con..ections 0 Ductwork Unnectie c-
TO
[3vunnect to existin
[3Refrigerant CC Crper_ p Support Attie Egeipmremt g �um
IME
❑ Duct Modifications
❑ Retrive out P pe 0$upply rlenum
• +
❑ New ❑ Reconnect 17 New 0 Reconne■t No Naw (w =1 wok}
yy.�p ❑ Now Duct System
U Refrige =mt Pipe Cv:vr rSRaiiim Plane... U No Duct Work
U CASH ❑ CHECK#
❑ Q ansion valve r ❑ New ❑ Reconnect
P ❑Foe! Piping
-T `1-402 tlectro..in Air i.loo. � _ —
W
Q CREDIT L�ARCi (EAST 4#s) �
stat yP U Electrical Wiring
aq
❑ Media Filter
0%onnecttorxisting VWermvSunioaPl..n-
EnP APPROVAL
Eleatrisa! in PEZ; 1 Tarm (364 days)
................_,__.,_,
OUR GUARANTEES
FINAN%IMG" r t-
0 ttiomfert ue-tutee U Fluma Prbteotiorl Goarantee
a'
CI 2, -Hour Service Guarantee ❑ 100% uncon'aitional Money-Saxx Guarantee
•PeymeaO F proved credit
1
■
`•AR5 is not responciblw fes.- pree;:atimg 8setwerk Sea 7e....7 sed C'omditiuRm a: the bmck of this aoonmanI for avinaa.
• Written coot.mr_r _othe.:-tiem -'II Be e5t'ned before beginning ....y wRforvwen odditiorial yr a. -.ended o k
• AI T CERIM5 FvR C❑tv5T-UU 1OM DEFECTS ARE 5067ECT IU THE NOT ICE AND CURE PROVISIONS OF CHAPTER 558.
FCOr11DA 5TA1 UUit5.
• au T ERIS RIGHT TO CANCEL' i nkc I-- Fie olicit.tio.. tale, and if yon do not want the goods or servi..W, you may Cancel
thL ••greernent Sy pre:fding :rittan nettae to tho _Ilor hi pe. -.on, by telegram; or by mail. This notice must Indicate "rat you
17w. -ml: :oRt tna goads a. ,urrri—and nest 5a dellverrtrd or postmarked before midnight or "re thin business Bay arcer you
_19m tfila ..greenlent. if you encal tfiia ograom.nL, :he seller may not keep all or part or any cash 'sown payment See we
referee aide hereof for an planation of this rlghL
• I a. uiawlaayu Thai my right io cancel has been a plained to me ofMly and in writing, and witflout waiving my right to cancel, I antheRee the
parfonnanco of the work, subject to all terms ant con'uitions set forth on the reverse si'oe hereof, plus any tax■a open —mplelien.
Notice To Owner - Do not sign this home improvement contract in Blank You are entitIM to a copy of the eeMrest at the time yen zigm.
Keep it to protect your leges rights. This home improvement contract may contain a mortgage =r ethe.-i- areata a hem - yve.- pmporty
that ut re losed on if you Mo not pay. Be =_m yea emaemlo 8 all p ieRU of Me eamt�t 6afem loo Jin.
mt
SIGNATURE Jl eaI11R.IR I ..ezZm' . yak
e.�.vR1�Ra++aR..ivR� DATE
0 2018 American Redid-ntW Sordes■ LLQ An right■ wnrved, ARS1078 11:0-.7