HomeMy WebLinkAbout7101 Hibiscus Rd. Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
4• J.
O �
Building Permit Application
Planning and Development Services
Building and Code Regulation Divh$ivn
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address;
Legal Description: Lavoff ( [ _
Property Tax ID h: � j=i Lot No.
Site Plan Name: Block No.
Project Name: cs
Setbacks Front Back: Right Side: Left side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with ton, SEER, IQ KW AC unit
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit — check a apply:
0HVAC Gas Tank ❑Gas Piping Shutters Q
_ Windows/Doors
OElectric 0Plumbing OSprinklers Generator Roof Roof pitzri
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ �I .` Utilities:�sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name, Name: Dennis Zacek
Address: Company: ARS American Residential Services
City: State:�Address: 2800 US Hwy 1
Zip Code: Fax: City: Vero Beach State: FL
Phone No. Zip Code: 32960 Fax:
E-Mail: Phone No. •-I aQ)3
Fill in fee simple Title Holder on next page (if different E-Mail: C50) `i CS -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 requited.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State,
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify 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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. 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,
accessory structures, swimming pools, fences, 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
commencing work or recording our Notice of Commencement.
Signature of O er/ Lessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF s,LLGe
The forgoing ins rument was acknowledge before me
this day ot 20 ,by
Dennis Zacek
pers cknowlqoging
Florida j
STATE OF FLORIDA
COUNTY OF 51Luce
The forgoing instr ent was acknowledged before me
this , day of 20 a by
Dennis Zaca
(Nae of person ackno I &),�y
gn ot
Na b isa i
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No V (Seal)
Commission No _-ffq (Seal)
MY COMMISSION # GG071535
Revised 07/15/2014 `` MY COMMISSION # C3G071535
EXPIRES February 09.2021 a EXPIRES February 09, 2021
REVIEWS
FRONT
COUNTER
PLANS
REVIEW
VEGETATION
REVIEW
MANGROVE
REVIEW
ZONING
REVIEW
SUPERVISOR
REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETE
INITIALS
Ins#allatlon Work
ork Order � st Start Date u�
_ C (772) 567-3100 Est. Completion Date
. right- L' V -� 28DO US Highway 1, Vero Beach, FL 32960 Corporate Customer
T M&ng it work. Making American Residential Services of Flunda, Inc. Relations
License 0 CMC1249753, CAC045878, CFC14282e3 (866) 803.0879
� EMAIL BALL SLIP
ADDREti�/O / Gtl'Y.'STATE: 2iP
s� y sf
HOMEPHON ' CELL PHQN WORK PHONE
YOUR HVAC SYSTEM DESIGN
3-
SIZE r�- TYPE SIZE t'L�TYPE ��-- SIZE TYPE
EFFICIE Y FICIENCY EFFICIENCY
$ $
$ Y $
$ - a
$ $ 213 to
SUBTOTA $ 3 SUBTOTAL $ SUBTOTAL $
MONT EST- $ MONTHLY EST," $ MONTHLY EST.- $
CUS OMER INITIALS _ _ CUSTOMER INITIALS.— _ CUSTOMER INITIALS
Warranty,' _ Parts _ Labor Warranty;riO -VF-- Parts v C Labor Warranty:' Parts Lab❑r
Compressor _ _.Heat Exchanger Q GCompressoADVii-feat Exchanger _Compressor _Heat Exchanger
?Unless otherwise noted, a I warranties are from the manufacturer.
• • • SELECTED OPTION: ❑ 1 2 ❑ 3
❑ Weatherproof New Plywood Deck ❑ UV Light
D'sconnect Reconnect Drain Line ❑ Humidifi SUBTOTAL $
Lifetime Egli tit ent Slab ❑ Ce ling Saver Kit ❑ Dehu id:fier $
Sound Isolation Pads (Pan 8 Float) ❑ Out oor Unit Pad
❑ Liquid Tite Conduit ain Drain Safety Switch ❑ Flue Vent�ng $
❑ Start Kit Seal Now Connections D
uctwork Connections" TOTAL $ :3
ra It Refrigeit LL Dryer_ ❑ Support Attic Equipment to existing plenum
)ELRefrigeranl Pipe .Supply Plenum ❑Duct Modifications
Reconnect lase Notes for scope of work)
❑ New
❑New Reconnect ❑New Duct System ,
.Refrigerant Pipe Cover Watum P(yum �No putt Worf� J.�❑ CASH ❑ CHECK#
❑ Expansion Valve ❑ New Reconnect (Fr
�y y ,❑Fuel Piping
AT-slat-Type1�A UJ ❑ a�tr�Xiraver CREDIT CARD (LAST 4#s) .. _.
c! � ❑Electrical Wiring
WConnect to Existing ❑ Medi❑ Home ServicePlan -
EXP _ _ APPROVAL _
Electrical ❑ PG 1 Term (364 days) - J,,
•UR GUARANTEES FINANCING- GR1iuiom -
724-HourService
Home Protection Guarantee
arantee100% Unconditional Money -Back Guarantee 'Payment options avaiiabe moth approved credit - — - A ..
rr I I
--ARS is not responsible far preexisting ductwork See Terms and Conditions on the bffckAf this document for details
• Written customer authorization will be obtained before beginning any unforeseen additional or extended work.
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 558
FLORIDA STATUTES.
• 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 right.
- 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 all terms and conditions set forth on the reverse side hereof, plus any taxes upon completion.
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 al rights. This home improvement contract may contain a mortgage or otherwise create a lien on your property
t =bforecloTd n if you do not ay. Be Sur ey u un rstand all p visions of the contract before you sign,
+ -3
CU OMER $IGNA URE DATE CO NY PRESEIVTATIYE
J It
CUSTOMER SIGNATURE DATE 6A
IL
0 201 a Ammican Residential Services LLC. A!I rights reserved. ARS1078 111017 g?r. e
Certificate of Product Ratings
AHRI Certified Reference Number: 9509434 Date : 06-15-2019 Model Status : Active
AHRI Type; RCU-A-CB
Series: COMFORT 14 AC
Outdoor Unit Brand Name: CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 24ACC442A'030`
Indoor Unit Model Number (Evaporator and/or Air Handier) : FB4CNF042L
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.
The manufacturer of this CARRIER product Is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 2101240 with Addenda 1 and 2, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 395DO
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.50
t,Active" Model Status are those that an AHRI Certifcatlon Program Participant is currently producing AND selling or offering for sale: OR new models that are being
marketed but are not yet tieing produced.'Production Stopped- Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Ratings that are accomoanied by WAS irdicate an involuntary re -rate. The new oubiished ral-no is shuvn alona vA h the orevicus fi.e. WA Si ratina.
DISCLAIMER
AHRI does not endorse the product(s} listed on this Certificate and makes no representations. warranties or guarantees as to, and assumes no responsibility tor,
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) nr 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 v,all only be "ad for Individual, personal and 14
confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; i
entered Into a computer database or otherwise utlllzed, in any form or manner or by any means except for the user's individual, Au
1
personal and confidential reference, AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION &REFRIGERATION 1NSTnUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate' link we make life better
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.
02019AIr-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 13205117"151295639