HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
0
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:
. - lylt'i►i'1TiTr=ate •.L�►5:��!� ����f►IIhJ:3:�Z
Property Tax IDd;onl . -�1-tlfm.5� Lot No. 11
Site Plan Nam— Block No.
Project NameQ��_
Setbacks Front O Back. Right Side- Left Side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with ton, SEER, to KW AC unit
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit — check all apply:
0HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sci. Ft. of First Floor.
Cost of Construction: $ VJ Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Dennis Zacek
�
Address: q�3j, h C tKra
Company: ARS American Residential Services
City: Stater,
Address: 2800 US Hwy 1
Zip Code: Fax:
City: Vero Beach State: FL
Phone No.
Zip Code: 32960 Fax:
E-Mail:
Phone No. ��a'��� -'� a®3
Fill in fee simple Title Holder on next page ( if different
E-Mail: :COr(N
from the Owner listed above)
State or County License: CMC1249753
If value of construction is 52500 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
commenciniz work or recordine vour Notice of Commencement.
_ Signature of 0 er/ Lessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF St Lucia
The Ding instrument was acknowledge efore me
thi day of 20 by
Dennis Zacek
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No E (Seal)
STATE OF FLORIDA
COUNTY OF StLuem
The forgoing instrument was ` C acknowledged fore me
this day of +� 20 by
Dennis Zaco
u re
Florida I
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. LIM KCR6 (Seal)
iw MY COMMISSION # MY COMMISSION # GG071535
Revised 07/15/20EXPIRES February 09, 202ti
EXPIRES February 09, 2021
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
MANGROVE
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETE
INITIALS
l�� !
1 ZO.••
Makin
MAkingit work.
Installation Work Order
(772)567-3100
2800 US Highway 1, Vero Beach, FL 32960
American Residential Services of Florida, Inc License 1r CMC1249753
EC13008558
Est. Start Date WI S
Est. Completion Date
Corporate Customer
Relations
(866) 003.0879
CUSTOMER n,1�t fkm
`���-i2 rl
EMAIL
CALL SUP
ADDRESS
CITY7STATEIZIP
HOMEPHONEr}-yrr)_ It Lj 314
CELL PHONE
WORKPHONE-]�
SIZE TYP8CEM ._ __
SIZE TYPE _
SIZE TYPE
EFFICIENCY C-09 _
EFFICIENCY __.
EFFICIENCY
$ Ml
$
$
SUBTOTAL $ �d
SUBTOTAL $
SUBTOTAL $
MONTHLY EST.' $
MONTHLY EST.* $ _ _-_ --_
MONTHLY EST.' $
CUSTOMER INITIALS
CUSTOMER INITIALS
CUSTOMER INITIALS
Warranty;"4CL Parts 15— Labor
Warranty:" Parts Labor
Warranty:" Parts Labor
Compressor -1-()—Heat Exchanger
Compressor -_Heat Exchanger
Compressor Heat Exchanger
'Subject to credit approval. Financing Provided by Greensky, Fixed interest rate of 6 99% for 61) months. Payment example assumes one-time $7,500 purchase on
approval data (APR 7.19%) with
1 payment of $02.69, 6 payments of $43.69, and 54 amortized payments of $162.28 Payments assume Account Activation charge of $39 applies and is duo with
firal required payment.Fixed interest rate of 9.99%for 84 monihs, Payment example assumes onetime $7,500 purchase on approval date (APR 10,15%) with
1 payment of $101.44, 5 payments of $52.44, and 78 amortized payments of $131.11 Payments assume Account Activation charge of $30 applies and is due with
fvsi required payment. Fixed inieresl rate of 9.9894 for 120 months. Payment example apr.umes ono -lime $7,500 purchase on approval date (APR 1 o.1 1 %) with
1 payment of $101.44, 5 payments of $62.44, and 114 amortized payments of $102 13. Payments assume Account Activation charge of $30 applies and is due
with first required payment -Fixed interest rate of 9.90% for 144 months. Payment example assumes one-time $7.500 purchase on approval date (APR lo.ogrib) wlih
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.
"Unless otherwise noted, all warranties are from the manufacturer.
SPECIFICS OF • •
SELECTED OPTION: ❑ t ❑ 2 ❑ 3
❑ Weatherproof ❑ Reconnect Drain Line ❑ Dehumid fie
SUBTOTAL $�
Disconnect ❑ Ceiling f%vRr Kit ❑ 0vidnor I J-lit Pad
❑ Lifetime Equipment Slab (Pan & Float) ❑ Flue Venting
$
❑ Sound Isolation Pads ❑ Main Drain Safety Switch ❑ Ductwork Connections'
❑ Liquid Tile Conduit ❑ Seal New Connections ❑ Connect to existing plenum
$
❑ Start Kit ❑ Support Attic Equipment ❑ Duct Modifications
d
❑ Refrigerant L.L. Dryer. _. 13§upply Plenum (see Notes for stops of wok)
LI12drigerant Pipe ❑ New Duct
TOTAL $ ��
CI Now�econnect System
❑ New "Reconnect %'R%urrl Plenum ❑ No Duct Work
❑ Refrigerant Pipe Cover ❑ New"Neconnect ❑ Fuel Piping
❑ Expansion Valvq , ❑ Electronic Air Cleaner _ ❑ Electrical Wiring
❑ CASH ❑ CHECK#
A•stal -Type W51 ❑ Media Falter r .-_ -_ _ _ ❑ Home Service Plan -
❑ Connect to Existing ❑ PCO 1 Term (364 days)
❑ CREDIT CARD (LAST 4#s)
Electncal ❑ UV Light
❑ New Rywood Deck ❑ Humidifier
EXP _ APPROVALOUR
GUARANTEES
❑FINANCING' bt:^-�:
mfort Guarantee me Protect -on Guarantee
[Z4-HOUTService Guarantee '�00% Unconditional Money -Back Guarantee
* I1rt r
Nv� 4 3` lr_0 51-I'l t•10
NOTES
'�O vnllnw�- Cali 1t�1,t..l�
�� th9��11 �v�Gr3�>1�iY
1ARS is not responsible for preexisting ductwork See Terms and Conditions on the back of this document for details.
• Witten 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 solicitatlon 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 after you sign this agreement If you cancel
this agreement, the seller may not keep all or part of any cash down paymenL 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 condition set forth on the reverse side hereof, plus any taxes upon completion.
Notice To Owner - Do not sign t me improvement contract in blank. You are entitled to copy of the contract at the time you sign.
Keep It to protVedo
Uri
his. This home improvement contract may contai ort g or otherwise create a lien on your property
thatcouldbeiou do not pay. Be sure you understand all provi on of 1 e t�ra�ct before you sign.
Oil0
CUS46 M R SIG A RE DATE COMPANY REPRESENTATIVE
t'r z r l
CU MER SIG ATURE DATE DATE
O 2 19 Amencan Rasdeniial Servicns LLC. All rights rast ed. AR51078 FL-190124 L 190124 B296
This combination qualifies for a Federal Energy Efficiency tax Credit when
placed in service between Feb 17,2009 and Dec 31, 2016.
Certificate of Product Ratings
AHRI Certified Reference Number: 201772425 Date : 06-24-2019 Model Status : Active
AHRI Type: RCU-A-CB
Series: PERFORMANCE 16 AC
Outdoor Unit Brand Name: CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 24APB642A'030'
Indoor Unit Model Number (Evaporator and/or Air Handler) : FV4CNB006L
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, 1D. IL, IA. IN, KS, KY, !A, MA, MD, ME, MI, MN, MO MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR. PA RI, SC SD, TN. TX, UT, VA VT, WA, VVV 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.productislresponsible for the rating of this system combination.
Rated awfollows in accordance withithe latest edition of ANSVAHRI 210/240 with Addenda 1 and 2; Performance Rating of Unitary
Air -Conditioning & Airy-Source'HeatPump Equipment and subject'to ralfrig accuracy by AHRI-SpoPsared, independent. third party testing:
Cooling Capacity (AZ) = Sing[ e or High Stage (95F), btuh : 40500
SEER : 17.00
EER (A2) - Single or High Stage (95F) : 1100
- '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
selling or offering for sale.
Ratings that are accompanied by WAS indicate an involuntary re -rate The now published rat-ng Is shown along with the previous (i.e. WAS) rating
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 product(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed In the
dhcctory at www,ahrldiroctory.:r*,
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Indlvidual, personal and
confidential referenve purposes. The contents of this Certificate may not. In whole or in part, be reproduced; copied; dlssominated;
entered Into a computer database: or othorw_se utilized. In any form or manner or by any means, except for the user's Individual,
AM
personal and confidential referenrc. AIR-CONDITIONING, HEATING.
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahrldlrectary,vrt; click on -Verifk Certificate" link my malt lite betrrr-
and enter the AHRI Certlf ed Relerenc� Number and the date on which the certificate was issued.
which Is listed above. and the Certificate No,. which Is listed at bottom right. rT - ""
02019Air-Conditioning, Heating, and Refrigeration Institute . CERTIFICATE NO.: t3205a697116]99984