HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (fl (c- 1 ! k Permit Number:
P
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
Address:
Legal Description:
Property Tax ID #t: � -1 • Aw• 6b Lot No. P
Site Plan Name: Block No. Im
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: 4
Replace AC, exact change out with ton, I y SEER, KW AC unit
CONSTRUCTION INFORMATION:
Additional work to e e orme m under this perit — check all apply:
OHVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �� Utilities: USewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ZWO
Name: Dennis Zacek
Address: �FJ� �C\�t Cif !�_ V�-
Company: ARS American Residential Services
City: 1Z � Luc,P_ _ Stater
Address: 2800 US Hwy 1
Zip Code: qC Fax:
City: Vero Beach State: FL
Phone No.
Zip Code: 32960 Fax:
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail: CSL.M, oa-VA(0.es • C-zy,(N
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
commencinh work or recordine vour Notice of Commencement.
�._ S
_ Signature of 0 er/ Lessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF stwu
The for ping instr meet was acknowledge before me
thisp`� day of ruy . 20 TCLby
Dennis Zacek
of perso cknpqedging
State of Florida I
STATE OF FLORIDA
COUNTY OF st was
The forgoing ins rument was acknowledge before me
thiOa day of 20 lnL by
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No (Seal)
COLEEN SULLIVAN
2 F; :r My COMMISSION # GG071535
Revised 071151
- EXPIRES February 09.2021
Commission NoG S (Seal)
_ My COMMISSION # GG071535
EXPIRES February 09.2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
4_ 10-0
Making it wo'k Makin
Installation Work Order
(772)567-3100
2800 US Highway 1, Vero Beach, FL 32960
American Residential Services of Rotida, Inc. License N CMC1 24975-
EC13008558
Est. Start Date 2i-t 7
Est. Completion Date&-ZY-14
Corporate Customer
Relations
(866) 803 0879
CUSTOMER
EMAIL
ly
q
ADDRESS CITY
fi
Asn
TE:ZIP
ci
HOMEPHONE
CELL PHONE v
ORKPHONE
OPTION I
OPTION 2
OPTION
SIZE "� TYPE _
SIZE 'z,5TYP�
SIZE - 'TYPE �f
EFFICIENCY (L��t? F (
EFFICIENCY .iLo er
EFFICIENCY_
.SPe(
$
$m—t
$
$
$rr�1//'
//��
$ 7.Jl4J,�_
SUBTOTAL
SUBT (L $__.._
SUBTOTAL $�.r�
MONTHLY L• $
MONTHLY EST.* $
MONTHLY EST. $
CUSTO ER INITIALS
CUSTOMER INITIALS
CUSTOMER INITIALS
Warranty: "_j!C>_Parts Labor
Wwranty:_J0 Parts Labor
Warranty: '_ZOL Parts Labor
10 Compressor L6 Heat Exchanger
,Compressor 1(�Heal Exchanger
!Q Compressor &� Heat Exchanger
'Sublrict to credits approval. Financing Provided by Groensky. Flied interact rate of 6,99% for 60 months. Payment example assumes one -lime $7,500 purchase on
approval date {APR 7.19%) with
1 paymcr I of $82 69, 5 payments of $43,69. and 54 amortized payments of $162.28. Payments assume Account Activation charge of $39 applies and is due with
first required payment.Fxed interest rate of 9.99r�; for 64 months. Payment example assumes onetime $7.500 purchasa on approval dale (APR 10.15%) with
1 payment of $101 44. 5 payments of $62 44, and 78 amortized payments of $131.11. Payments assume Account Activation charge of $39 applies and is due with
first required payment. Fixed interest rate of 9.994s for 120 months. Payment example assumes one -lime $7,500 purcaase on approvu I date (APR 10.11 %) with
1 payment of $101.44, 5 payments of $82 44, and 114 amortized payments of $102.13. Payments assume Account Activation charge of $39 applies and is due
with lira required payrnent.Fixed interest rate of 9.99� for 144 months. Paymuns example assumes one-time $7,500 puiebase on approval date (APR 10.09%) with
1 payment of $101.44, 5 payments of $62.44, and 13a amortized payments of $91.62. Payments assume Account Activation charge of $39 applies and is due
with first required payment.
"Unless os-rerwise noted, all warranties are from the manufacturer
• • •
SELECTED OPTION: ❑11❑r 2
❑Weatherproof ❑ Reconnect Drain Line ❑Dehumidifier
SUBTOTAL $'(1CIJU
Disconnect ❑ Ceiling Saver Kit ❑ Outdoor Unit Pad
{i`L�(etime Equipment Slab (Pan 8 Float) ❑ FIy , Venting
$
13 Sound Iso'alion Pads ❑ Main Drain Safety Switch uctwork Connections'
❑ Liquid Tile Conduit ❑ Seal New Connections ❑ Connect to existing plenum
$
❑ Start Kit ❑ Support Attic Equipment ❑ Duct Modifications
JE339frigerant LL Dryer_,_,. P'Supply Plenum (see Notes for scope of worW
Pipe [INew
❑�,,N
�+
TOTAL $
Zerigerant EYRIeconnect w Duct System
Now ❑ Reconnect �eturn
Plenum r5� o Duct Work
❑ Refrigerant Pipe Cover ❑ New 0161connect ❑ Fuel Piping
❑ Expansion Valv.el' ❑ Electronic Air Cleaner — ❑ Electrical Wiring
tat —Type Z ]C ❑ Media Filter ❑ Home Sere ce Plan —
Vc�-nnect
❑ CASH ❑ CHECK#
to Existing ❑ PCO 1 Term (364 days)
REDIT CARD (LAST 4#s)
Electrical ❑ UV Light
❑ New Plywood Deck El Humidifier
EXP _ - APPROVAL
OUR GUARANTEES
❑ Comfort Guarantee [I Home Protection Guaranies
❑ FINANCING'
❑ 24-Hour Service Guarantee ❑ 100% Unconditional Money -Back Guarantee
•
'ARS 's not responsible for preexisi'ng 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 SUBIECTTO 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 mall. 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. 6ubject 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 lime 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
'Just`uld be foredosod on if don ay. Be sure you understand all provisions of the contract b yo n.
-clifrOMEA SIGNATURE DATE COMPAkrlf 'RESENTATIVE
/TU— 11
CUSTOMER SIGNATURE DATE DATE
0 20 so American Residential Services LLC. All rights reserved. ARS1078 FL_190124 L190124 8256
Certificate of Product Ratings
AHRI Certified Reference Number : 7490502 Date: 06-22-2019 Model Status: Active
AHRI Type. SP-A
Series - R41 OA AC SPP
Outdoor Unit Brand Name. CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 50ZPC030---30•'
Region All (AK. AL. AR, AZ. CA, CO. CT, DC, DE. FL GA, HI. 10, IL IA, IN KS, KY, LA, MA, MD, ME, MI, MN, MO. MS,
MT. NC, NO, NE NH NJ NM, NV NY, OH. OK OR, PA, RI, SC, SO. TN, TX, UT, VA, VT, WA, WV. Wt, 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 foilows in accordance with the latest edition of ANSUAHRI 2101240 with Addenda 1 and 2, Perforrhance 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 ; 28600
SEER: 14.00
E E R (A2) - Single or High Stage (95F) : 11,50
t"Active- Model S1alU5 are those that an AHRI Certification Program Participant is,urrently producing AND selling or offer rig for sale. OR new models that are being
marketed but are not yet being produced "Production Stopped' Mode, Status are those that an AHRI Certification Program Participant is no longer producing BUT is si .I
selling or offering for sale.
Ratings that are accompanied by WAS indicate an involuntary re -rate The new Published ralina Is shown a and with the otev-ous ft.e WAS) ratino
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 Ilabil,ty 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 1_sted In the
directory at www.atirldliectoty.org.
TERMS AND CONDITIONS
This Certificate and Its contents are pmprletary products of AHRI. This Certificate shall only be used for Individual, personal and
confidential reference purposes. The contents of this Certificate may not, In whole or In part be reproduced: copied: disseminated;
entered Into a computer database: or otherwise utilized, In any form or manner or by any means, except for the user's Individual,
personal and confidential reference. AIR-CONDITIONING, HEATING.
CERTIFICATE VERIFICATION & REFRIOERATiON INSTITUTE
The Information for the model cited on this certificate can be verified at www.ahridirectory.org click on 'Verily Ce rtl flcate' link we mat.: life hctirr,
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 r— --- -- -- -
®2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132056W598049427