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HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO (MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: icy I r t'"4 Permit Number: s ­_ . '.. 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 _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: ; Legal Description: ( riV o i tom) _V 71 nR-"tZAVAO I r;� Q Property Tax ID It: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: _ Left Side: I DETAILED DESCRIPTION OF WORK: Replace AC, exact change out with a•5 ton, SEER, KW AC unit CONSTRUCTION INFORMATION: Additional work to orme under this —checkpermit a apply: e e �HVAC � Gas Tank Gas Piping Shutters Windows/Doors Electric El_ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $^ _ Utilities: Sewer 0Septic Building height: OWN ER/LESSEE: CONTRACTOR: Name MLXWSA Name: Dennis Zacek Address: Company: AIRS American Residential Services City:Wm_ State:' Address: 2800 US Hwy 1 Zip Cade Fax: City: Vero Beach State: FL II Phone No. L- c5 �� Zip Code: 32960 Fax: E-Mail: Phone No. --Actti-} --A a�3 Fill in fee simple Title Holder on next page ( if different E-Mail: • S •��1 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, 5t. 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 ~ STATE OF FLORIDA COUNTY OF sccvve The forgoing instrument was acknowledged efore me this day of 20 LIby Signature of Contra r License Holder STATE OF FLORIDA COUNTY OF S+L,ae The forgoing instrument was acknowledged before me this aL day of 20 t $ by Dennis Zaeek Dennis Zacek {Name of person a owledging } (Name of person ackn w edg' g } Sig cure of P - tate of Florida } Vgn,Re of No lic- State of Florida ) Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No 5 (Seal) Commission No. "1J (Seal) COLEEN SULLIVANCGLEEN SULLIVAN ,;.. MY COMMISSION # GG071535 Revised 07/ i 5/2 4',' • EXPIRES February 09. 2021 MY COMMISSION # GG071535 '4"" •�o:� ,.' EXPIRES February 09.2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 5EA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS IN, Making .t right: making!' work. Installation Work Order Est, Start Date r ! (772)567-3100 Est. Completion Dal 1 7117- 2800 US Highway 1, Vero Beach, FL_ .�2960 Corporate 6USIer A.Terican Residential Services of Florida, 4,r. L ,verse N C:MC 1249753. Relations EC 13008558 (866) 803.0879 CUSTOMER G1 Jl l EMAl1 CALL SUP ADDRESS aLt n tp rot J J CITY!$TATEIZIP -� t �► G-e / HOME PHONE CELL PHONE-^7�y�. WORK PHp SO� -S / /•' � OPTION • OPTION SIZE25660 TYPE _AC,,�,Cmjr TYPE SIZE TYPE EFFICIENCY EFFICIENCY EFFICIENCY $ $ $ {� �V $— 7 $ $ SUBTOTAL D SUBTOTAL $ SUBTOTAL $ MONTHLY EST • $ MONTHLY EST. • $ MONTHLY EST.- $ CUSTOMER INITIALS CUSTOMER INITIALS CUSTOMER INITIALS _ Warranty'"-Ir Paris Labor Warranty:" Parts Labor Warranty:'_ _Paris Labor r Compressor r Heat Exchanger Compressor Heat Exchanger Compressor Heat Exchanger 'Subject to credit approval. Financing Provided by Greensky. Fred interest rate of 6.99% for 60 months. Payment example assumes one-time $7,500 purchase on approval dale (APR 7.1 Ae} with I payment of $82.69. 5 payments of $43,69, and 54 amortized payments of $162.26. Payments assume Account Activation charge of $39 applies and is due with that required paymant.Fxed interest rate of 9.g94h for 84 months. Payment example assumes one-time $7.500 purchase on approval date (APR 10.15%) with 1 payment at $101,44, 5 payments of $62.44, and 78 amortized payments of $131.11. Payments assume Account Activation charge of $39 applies and to due with first required paymont. Fixed interest rate of 9.99%for 120 months. Payment erample assumes onetime $7,500 purchase on approval data (APR I0.1 Iq6) 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 list required payment.Fixod interest rota of 9.99% for 144 months. payment example assumes one-time $$500 purchase on approval date (APR 10.09%) with 1 payment of $101.44. 5 payments of S62.44, and 138 amorlized payments of $91.62. Payments assume Account Activation charge of $39 applies and is due with ft%l required paymont. "Un4}ss otherwise noted, all warranties are from the manufacturer. ❑ Weatherproof ❑ Reconnect Drain Line Discunnect ❑ Ceiling Saver Kit Lifetime Equipment Slab (Pan & Float) ❑ Sound Isolation Pads ❑ Main Drain Safety Switch ❑ Liquid Tite Condu:t ❑ Sea' New Connections ❑ Start Kit ❑ Support All c Equipment ❑ Refrigerant LL Dryer_ ❑ Supply Plenum ❑ Refrigerant Pipe ❑ New ❑ Reconnect ❑ New 3 Neconnect ❑ Return Plenum ❑ Refrigerant Pipe Cover ❑ New ❑ Reconnect ❑ Expansion Valve 'F �stat -Type 64— El Electronic Air Cleaner ❑ Media Filter 'Connect to Existing ❑ PCO Electrical ❑ UV Light 214ew Plywood Deck ❑ Humidifier Comfort Guarantee 24•Hour Service Guarantee ❑ Dehumidifier ❑ Outdoor Unit Pad ❑ Flue Venting ❑ Duclwork Connections' ❑ Connect to existing plenum ❑ Duct Modifications (see Notes for scope of worW ❑ New Duct System ❑ No Duct work ❑ Fuel Piping ❑ Electrical Wiring ❑ Home Service Plan - 1 Term (364 days) SELECTED OPTION; 01 ❑ 2 ❑ 3 SUBTOTAL $ 41 L( $- 7yy TOTAL $ ❑ CASH ❑ CHECK# CARD (LAST 4#s) As_cL EXP APPROVAL ' I-Ql-lome Protection Guarantee � ❑ FINANCING 100% Unconditional Money -Back Guarantee p- L4 , 0 _5Z-,Vt3 f,�r? p(IJr�>`J; �L1,Jh o� ! 1 I1'n� Cv} Evr1e✓ G>exf Gvv�c•� f'IS ��� f ��rrf r.�1 o r rC f.0 �t..Y1.� ro ra •�►'� 2 y/,•, o it/a l�%r7�PSi 'ARS is not responsible for preexisting ductwork. See Terms and Conditions on the back of Iles 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 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 agreemenL 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 rlghL - 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 legal rights. This home improvement contract may contain a mortgage or otherwise create a lien on your property that cool be ore sod on if you do not pay. Be sure y u understand all provist of the contract before you sign. �RIE CUSTOMER SIGNATURE DA E MPANY REPRE �O CUSTOMER SIGNATURE DATE DAT 0 2019 Amarir�n Residential Ser„ices L.C. All r'�h14 ieserved. ARS 1076 FL_190124 L190124 8256 Certificate of Product Ratings AHRI Certified Reference Number 9474297 Date : 06-21-2019 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) : 24ACC430A'030' Indoor Unit Model Number (Evaporator and/or Air Handler) . FB4CNF030L 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, 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 follows in accordance with the latest edition of ANSI/AHR' 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-spor-sored. Independent, third party testing; Cooling Capacity (A2) - Single or High Stage (95F), btuh : 26200 SEER! 14.00 EER (A2) - Single or High Stage (95F) ; 12.00 t'ACtive" Model Status are lh*se that an AHRI Certification Prog: am Participant is currently producing AND se-ing or offering for sale; OR new models that are being marketed but are not yet being produced.-Produclion Stopped` Model Status are those that an AHR Cen-ficat'on Program Participant is no longer producing BUT is still selling or offering for sale Rat nqs that are accompanied by WAS ndlcate an Involuntary re -rate The new oubGshed rating Is shown slona with the previous ii.e. WAS) ratino. DISCLAIMER AHRI does not endorse the products) 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 product(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.ahrid. rectory.arg, TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and confidential referencerenceppurposes. 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 & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridlrectery.arp. dick on'Vorlf) Certificate' link xr m Z - fir. '•. u: r and enter the AHRI Certified Reference Number and the date on which the cert flcate was ;ssued which is listed above, and the Certificate No., which Is listed at bottom rlghL ©2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 132055932327072504