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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Gaee�, Ga 10 Permit IQumBer: s s Building Permit Application rlw,,,,,,.g—it VU ar�F.... „t5�- dcr,-Iu.y was wac HcyaluGo" 0;9"- "W" 23OU v;, y,*„,'a Are„ue, Fort Pie, ce FL 34982 _ Phone: (/72) 462-1553 Fax: (772) 462-1578 L.Ommercial R-CAerltial _ PERMIT APPLICATION FOR: To Select from dmpbox: click arrow at the end of line PRuPuSED IMPROvERIEI9 I WC.A 11014: Address: �- n CegalDescription:C'XaCk Ai_ �[_\(1(lY`VqLQ a_)k- Vy)� AuCA- Q Property pax ID a: aiLe Plan Mame: Project Mame:Q Setbacks Front, back: RigRt aide: len biu.: Lot No. Block No. DE I RILED DE51LRIP I IuM OF WORK: I Replace AC, eAaLt change oat with on, SEER, KW HC unit `�� LwvL - LUM51170ElIVN IIWORIGIAIION: j Additional work to brtormed under this permit — c ec aftp,-,,: e eMVRE: Gas ianR ❑Gas Piping Rpttcr. �Windows/Doors Electric U Plumbing []_)pringlers E Gerrer..tor Roof Root pitch notal Sq. r► of Construction:s Ft. yr Hr..t Floor: Cost ei Con;traetion: 1=)t LJtilities:Sewe171 rSeptic Building ReighE: UVAER/[E55EE: LUN I FMCWR: Name (game: Dennis Zacek AMUress: Comeany: ARS American Residential services City: S.a,e:S�7(. Address: 1600 05 AWy Zip Code: Fax: Ci,y; veto 6eacR Stot�: FL Phone Ido. Gip C,0e: 32960 Fax: E-mail: PhoneNo. ic�-�`�� •� a�3 Fill I.... icc Impie Title Holder on next page (if different, E -Mail: � i QsJ • C -L'A'M from the Owner 16 -ted above) -itate or Count, Circri.,c: CMC1249753 It varue OT consirucuon is azsuo or more, a RECUROEU 14.tiac eT Cvrnrnerlee... erlt 13 reyeir0. 1 5uPPEEME19 I A[ UUNb I Rue, I JU19 [IEIa LAW INFORMATION: DESIGNER/ENGINEER' = Not Applicable Name: _ Address: City: Zir: Phone: State. FEE SIMPLE TITLE HOLDER: x Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: X Not Applicable Name: Address: City: State' Zip: Phone: BONDING COMPANY: X Not Applicable Name: Address: City: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. at. [ucie Lounryy mares no representation tRat is granting a permit will autnorize the permit Rolaer to Rui1t7 the select strecterc which is in conflict with anx a plicable Home Owners AsSOClaLion rules, bylaws or and covenants that may restrict or prohibit sucR zrreeterc. Pleo,c con.elt ..itl�yoe.- Rom7c 0 -mer.. Asaoci-rion onoyour 8ce8 for any rc,triction, ..n1.cR ..ay .pply. In consilleration or the granting k tRls requesiea permit, I lio nereffy agree tRat I will, in aii respects, p�Rerm� tRc .erR i.. accordance witR tree Ppproa,, pla;, trlc Florida Building Codc5 and 5t. Cacic County Amendments. The followins building permit applications are exempt from undergoins a full concurrency review: room additions, accessory structures, swimming pools, rences, walls, signs, screen rooms ..ma acce;moo. , a3ez to omotncr nen-residcmtiol a,e wAKFVI G 10 OvvMER: Your rtlarc to Ravc,a a Notice oi Cc. ...... ence... e..t may result in Your rayin6 twice for improvements to your property. A Notice of COmmencement must be recorded and pOsted on the jobsiLe before the first inspection. If you intEnd to obtain financine, Lz-,n3alt with lender or an attorney before commencing work or recording your Notice of Commencemeni. ' Jam+s _ bignaterc et v er/ [e�:icc/A6mmt signature of Contradgrfficensi Molder a 1 Ao I! OF rL vRIuF► COUNTY OF atr-- he forgoing in u.r t as acknowledse efore me tR day o 20 6y (game of Dennis Zack ]tat. or Florian ) Pc. jon.11y Rno... x OR Produced Identification ype or leentirlcation Proaucea Com,;--iz,ion iQe a ►''; GOLttR 3uLLIVAN M, COMMI551UN $ uta0I, U3 Revised 07/15/2014 = Insrallarion wom v. aeff . , ■ (772)567-3100 r�r 2800 US Highway 1, Vero Deach, PL 3zaov IOlakine it right,.merken ,.emocn;iel oernces of Plaripa, 6 c ri,crrse w C.0 i 2.975 Making .1'Kark' EC ° 3008558 Est. Start Dale E=11. E=1. Completion D_ Corporal 3, Relotione (.too) 803-0879 1 CUSTOMER M l 4III I CALL SLIP 31ZE C _ TY E Lj4 of JU 14 EFFIi.IENvr �. $ SUBTOTA MuNTHLY E51' Ti C.uS I DRIER IMI t In[5 SIZE TYPE EFFIDENCY SUBTOTAL $ MONTHEY EST.* zii `1;U5iUMER IMITIAES G4,e 51Gt TYPE EFFICIENCY 3 3 SUBTOTAL $ MONTHLY EST.' $ GFib1OMER INITIALS Warranty;" Parts Labor vvarranty:" Parts ®Dor vva.penty:" Part= Lazo, Al „Comprcuawr Hear Eniich„ngcr i Compressor Heat INchanger %ompressor Hca! Exeh-gcp 'S-oj■■t to .radit F._■ei.a Pw.ided 51 Gr■■n-k,;% Fred iat..wt vol, .f fi.99% f.p 00 ...e�:he. P_ymee: ex,.reple ..eaumoa aro-ame S.'Ovv Pu.,...,se oa cppro-_1 da:e (APR 7.19461 --h i paym • fee9C:S p 5+ !s r 3 SV,4141J�; itmvria4n6 eal. ur-- 2.1 errs ine Ac wunf.A=iv arerrrhF�39 du -ifh first r yrt»rN,fi 9 99°c firt)d .laitymem : air�p a- - time 37.'SL7r1 pnch a. r pre. h 1 p.,—... cis 11 I. L.:.L d wwry.r .y t due with ,esi reqs ! a 9.1pr r zv munit to apurcha3e n ap0 , ym 1 0 d 114 smo .nt_ of $1 1 w -e z zolill..A�■.nllo tr{• a cue dh a-1 �e pa,,. 4L ed:ntwvzl rote of 9.99% fe. 144 Rren:ha. P_ymenI a.='pie am.5 on. ime $'7vv pp. Ise [x slp Jptiotoma pp. i SJ:Ce) witR - payment at $ t a p,ymer;, „r $o2-, — i .a am„n¢eo paymenls ur $e i.07 Puymvnte assume r.ccounI Activation' Charge of s.39 apph■rntnd w do. "70 first req,i:rod payment. f U.I.- rrho iw rrm-w, al w.nanties,., 6..m I=- m,.mr,ctorer. ❑ Wvn;hcrprouf Di=eenR�rt ❑ Lifciimo Egoipmcnt Slab 0 50_Rd 1=vhJiw_ Ped= ❑ Liqu;d Tito Conduit ❑ 5t..rt K;t efrigerant LL Dryer_ -&origVMRt Pipe ❑ Mew reconnect -. E3 Rclrigerrmt Pipe Cc:cr ❑ Expansion Valy _ ati=t IypcA_1E o%onnect to Ex�sting E',ectricoi G Mew P ywood Deck ❑ Reconnect Drain Line ❑ Dehumidifier ❑ Coiling 5v, -r Kit ❑ u-alaeer Unit Pad i=an & Floatr ❑ Flue Venting ❑ Rh., Diin 5..Icty 5 tch ectwcrk Cor ineotioncr G Seal New connections PLvnneci to existing PEnum Support A;;ic Equipmeni ❑ Duct M5 ih.a.n., upply I •num (-- N-1- r.. --p. of work) ❑ Now Rccon„eci ❑ Now Duct System )'Return Plenum u Mo Duct vvohr ❑ Now cconncci ❑ Fucl Piping 17 Electronic nip Cleaner _ G Electrical Wiring ❑ Mcai.. Fil;vr ­t� Home Sat7ioe Plan - © rcr term j364 days? ❑ UV Light - u RepniB�fiep Geammice Service Guarantee PMi, 4 z7 SELECTI'wv vPTly :1' ❑ 2 ❑ 50BTOTAL $ TOTAL $ ❑ i,A3M IIUK# ❑ CREDIT CARD (LAST -.*s) EXP _APPROVAL u FINANCING* Pristc 1614 Gm_ranl=a Unconditional Money -Back cauarantee udal -102Z/8 'ARS is 1`101 rcaponE b1m fur p -e-27, t.„g aecnrark. 5cc Terms r.nd Conditions on 'rhe back of ;hz document for details. • Wr Iton Lzstca.cr be ab;-ned before beginn „e ,ny anfo.cxcn aadiil.rnnl or e.iended work. -ANY CI AIMS FOR CON5I ROCTION DEFEUrb ARE 5U B1ECT TO THE NOTICE AND CORE PROVISIONS OF CHAPTER 558, FLORIDA STATUTES - BUYER'S RIGHT TO CANCEL' This ie a home olli5tallan awls, rind if yon do not Rant the goods or servi..a,, you may cancel this agree• mornt by pro-viding writte.-...asilts:10 the sallor i7i paean, by torlelimm, or by moll. This notice r�.oat indicate that you do not want the goods or awrrlcc., end meet Be dali:ored or postmarked berfo.w midnight of the third boaine97 d..y oftcr y.,o Nign this agreemorni: If you cancel this egrouman%the ,aller mry rot deep all or port of any yah da -n poym-tit Scor 168 ruiene aiae Fiereaf for an explanation of this right • I acTincraleage th,l my i sg"t to can -1 F,s Fee,, e.piai,,ed to mm arally and to v nr .,g, wed 1i' ' ata,;, my nyhi to u cl, I .rothoriza the performance of the -.ark aebteet to a' tonna _nd cendillam3 act forth en th. rarcrae side howl, p'e^ acs opo compI. or. Bailee to O—or - Qo net aipn this Remo impra-e... ant eo..tnlct in 61.. a era entlu o .. fly of Ute contract wt the times you sign. r4ep It to "fact yve. leg -1 rights. I nis Rorie Imp.-v:eRlo.-.t„ mtnrct n�::y fain a o iig or otharml.,a crorwty w lion on your property tiI tWJ-1 be fo �doseaodif you riot pay. Be moons goo o.raarstand all p rislons o roe nua� Eglare you sign. ���� CUSTOMER SIGNATURE DAr F. FRFSF. + - 0173 _—RteR 3IaRn�eR. a,,:f! T F151-1 -, -_ _ mun 0 2019 nenResdential Service■ LLClim . n8 ngllts e—, nRS rmie_FL. 16012. L100124 R.-59