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HomeMy WebLinkAboutPermit app 2921 HarsonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I Permit Number: Itm ' Building Permit Application Planning and Development Services 80ding and Code Regulation Division 2300 Virginia Avenue, Fort Pierce 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: e - Legal Description _ { ( ��MA oacc 1 �` �77 Property Tax ID #:r * tin'lul =_ Lot NO. n Site Plan Name: Block No. 4 Project Name:��._. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Replace AC, exact change out with - rJ ton, SEER, KW AC unit CONSTRUCTION INFORMATION: Additional work to be ertormed under this permit —check all apply: �IHVAC Gas Tank Gas Piping In _ Shutters Windows/Doors Electric 0 Plumbing Sprinklers []Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ Utilities:11 Sewer E Septic Building Height: OWNERAESSEE: CONTRACTOR: Name ' MP Name: Dennis Zacek Address: Company: ARS American Residential Services City: Stater Address: 2800 US Hwy 1 Zip Code: Fax: City: Vero Beach State: FL Phone No. -A Zip Code: 32960 Fax: E-Mail: Phone No. ��c --5cSt } •� Fill in fee simple Title Holder on next page { if different E-Mail: Q5Q\ ' Q&V\Ao �s • Cnm from the Owner listed above) State or County License: CMC1249753 if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 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 vour Notice of Commencement. —Signature of 0 er/ Lessee/Agent Signature of Contra r/License Holder STATE OF FLORIDA COUNTY OF situve STATE OF FLORIDA COUNTY OF Stlnae The forgoing instr ment was acknowledge efore me I The forgoing instrument was acknowledgXby fore me this day of by this LAY, day of �.�_ 20 Dennis Zacek Dennis Zacvn person c nowledg ng) (Name of person ackno I dging I f� _ e o N a u (Mgna otary bl - t a lorida I Personally Known x OR Produced Identification I Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No (Seal) SULLIVAN Commission No.„)j (Seal) MY COMMISSION # GG071535 J My COMMISSION # GG071535 Revised 07/15/2014 =�q ry 09EXPIRES February 09.2021 EXPIRES FebruB .2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS y / rk. Making it right. . Making it wo f Installation Work Order C5;tpr1AWEst. Start Date Orr 0 7 (772)567-3100 Est. Comp'olon Date 41 � 2800 US Highway 1, Vero Beach, FL 329C� Corporate Customer" American Residential Services of Florida, Inc. Licemo 1' CIv1C I?413753. Relations ECT3008558 i666) 803•DS79 USTOMER r • r EMAIL CALL SLIP ADDRESS LKW CITY.-STA HOME PHONE CELL h j WORK NE • • 1 OPTION 2 OPTION SIZE t TYPE SIZE TYPE r' SIZE TYPE _ EFFICIE EFFICIENCY !fl EFFICIENCY _ $ $ $ SUBTOTAL $ SUBTOTAL $�_ SUBTOTAL $_ MONTHLY ST.' $ MONTHLY EST' $ MONTHLY EST.' $�� CUSTO ER INITIALS CUSTOMER INITIALS _ _ _ CUSTOMER INITIALS Warranty:" Parts Labor Warranty:' Parts Labor Warranty-: ' Parts Labor Compressor Heal Exchanger 0AIC,Compressorl&X9Heat Exchanger Compressor Heal Exchanger -ouatect ro creon approval. 1, nano mg F'rowdad by Greensky Fund intorest rate of 6 99% for 60 months. Payment example assumes one time $7,500 purchase on approval date ?APR 719W. w tit 1 paymonl of $82.69, 5 payments of $43,69, and 54 amortized payments of $162.28. Payments assume Account Activalion charge of $30 applies and is due with first required payment Fixed interest rate of 9.994b for 84 months. Payment example assumes one -lime $7,500 purchase on approval date 1APR 10.15%6 with 1 payment of $101.44. 5 paymente of $62 44. and 78 amortized payments of $131.11. Payments assume Account Activalion charge of $39 applies and is due with first required payment Fixed interest rate of 9.9946 for 120 months. Payment example assumes onetime $7,500 purchase on approval date (APR 10.11 %) with 1 payment of $101 44. 5 payments of $62.44 and 114 amortized payments of $102 13. payments assume Account Activation charge of $39 applies and is due with first required paymenl.Fixed interest rate of 9.90% for 144 months. Payment example assumes one-time $7,500 purchase on approval date (APR 10.09%) with 1 payment of $101,44. 5 payments of $62.44 and 138 amortized payments of $91.62 Payments assume Account Activation charge of $39 applies and is due with first required payment "Unloss otherwise noted, all warranties are from the manufacturer Disconnect Lifetime Equipment Slab Sound Isolatian Pads Liquid rite Conduit ❑ Start Kit ufrigerant LL Dryer_ efrigera t Pipe ❑ New CRecennect Refrigerant Pipe Cover Expansion Valve stal —Type Connect to Exiidng Electrical ❑ New Plywood Deck econnect Drain Line 13 Ceiling Saver Kit (Pan & Float) Main Drain Safety Switch Seal New Connections Support Attic Equipment KSupply Plenum New ❑ Reconnect Id Return Pienern .61"APa ❑ New ❑ Reconnect ❑ Electronic Air Cfea er ❑ Media Filter ❑ PCO ❑ UV Lioht _ Comfort Guarantee 24-Hour Service Guarantee l-wf- 144-14 - 'usk 4- de,!IJ ❑ Dehumidif,e ❑ Outdoor It Pau ❑ Flue Venting ❑ Ductwork Cenneclronsl Connect to existing plenum Duct Modifications (sae Notes for scope of work) ❑ New Duct System No Duct Work ❑ Fuel Piping ❑ Electrical Wring ❑ Home Service Plan — 1 Term (364 days) Home Protection Guarantee 100% Unconditional Money -Back Guarantee NOTES SELECTED OPTION: ❑ 1 *,� ❑ 3 SUBTOTAL $ TOTAL AJA $ 3 4 ❑ CASH ❑ CHECK# ❑ CREDIT CARD (LAST 4#s) EXP APPROVAL FINANCING` fl (i T--srA- �. 9 Air,,. niz 'ARS is not responsible for preexisting ductwork. See Terms and Conditions on the back of 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 agree- ment 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 atter you sign this agreemenL If you cancel this agreement, the seller may not keep all or part of any cast) 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 waning 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 legal rights. This home Improvement contract may contain a mortgage or otherwise create a lien on your property Id be forec0ed on if you do not pay. Be sure you understand all p visions of the contract before you sign. f.ud G,rn,r•� �[ l CUSTCJMER SIGNATURE BATEI IGO 11ASERESENTATIVE CUSTOMER SIGNATURE GATE 0A C c 2019 American Resadonlixl Services I. LC. All rights reserved, ARS 107a FL_14a124 L190124 B255 Certificate of Product Ratinas AHRI Certified Reference Number: 9509434 Dale : 05-18-2019 Model Status: Active AHRI Type: RCU-A-CB Series: COMFORT 14 AC Outdoor Unit Brand Nome: CARRIER Outdoor Unit Model Number (Condenser or Single Package) : 24ACC442A'030' Indoor Unit Model Number (Evaporator and/or Air Handler) : 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 AN 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), bluh ; 39500 SEER: 14.00 EER (A2) - Single or High Stage (95F) . 11.50 t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND sell,ng or offering for sale, OR new models that are being marketed but are not yet being produced.'Production Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still glling or offering for sale winas that gre accompaniod by WAS indicate an imoluni, ry re-r.5te The new o-rblishod rallnq is shovm Mono with the orovious 4im. WAS ralirm. 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 for, 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 producl(s), or 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 shall only be used for Individual, personal and AI confidential reference purposes_ The contents of this Certificate may not, In whole or In part, be reproduced; copied; disseminated, 111w% entered Into a computer database; or otherwise utilized, in any form or manner a r by any means, except for thr user's individual, personal and confidential reference. AIR-OGNOMONING, HEATING, CERTIFICATE VERIFICATION A REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org. click on 'Verify Certificate' link tw make lih. hetter 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 ©2019AIr-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132Q53373393239031