HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
ti I J
A
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 rJ \
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: �- C e_
I
Legal Description: I L['� QI� b.na ;_k,NaQQ� 0q- meoQ10(t a.'�L�_.2 �,�
Property Tax ID #., Lot No_
Site Plan Name:1-'a -p�iI�QQQ {� �Q�'Block No.
Project NameGAZU ,�(���{'� _
Setbacks Front Back: Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with ton, SEER, KW AC unit
Haaiuonai worK zo oe errormea unaer inis permit - cneCK an apply:
1:JHVAC Gas Tank Gas Piping Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers t-�.I_ Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �V3 , Utilities: USewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name L
Name: Dennis Zacek
Address: —' a
Company: ARS American Residential Services
City:r3ry 7V State:
Address: 2800 US Hwy 1
Zip Code: i k Fax:
City: Vero Beach State: FL
Phone No,
Zip Code: 32960 Fax:
E-Mail:
Phone No. ��e7'��t-} •� a
Fill in fee simple Title Holder on next page { if different
E-Mail: S " a+\J S • cor(1
from the Owner listed above]
State or County License: CMC1249753
IT value or constructcon 15 5z50o or more, a RECURDED 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 your Notice of Commencement.
_ Signature of 0 ,er/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF StLude
The for oing instripment was acknowledgec].pefore me
this day of � 20 ``-��� by
qp.,". s
SigDna
ure of Contra r/license Holder
STATE OF FLORIDA
COUNTY OF stLucn
The forgoing instrument was acknowledged before me
this _ day of , 20 _by
Dennis Zacek Dennis
[N me f person ac owl ng) (N a person ac o le - g I
, I
ig e D u ic- ate of Florida I tg e o ry u c- State of Florida)
Personally Known x OR Produced Identification
Type of identification Produced
Commission No (Seal)
Personally Known x OR Produced Identification
Type of Identification ProducedC
Commission No� `].SS (Seal)
Revised 07/15/201 ;'e MY COMMISSION # 0G071535 - COLEEN SULLIVAN
�y+ - EXPIRES February 09.2021 MY COMMISSION # GG071535
REVIEWS
FRO
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
. �...
V
REVIEW
ROVE
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
0-xI ,l
= �•'
akin
Making it work. M
Installation Work Order
(772)567-3100
2800 US Highway 1, Vero Beach, FL 32960
American Residential Services of F orida, Inc License 0 CIVIC 1249752
EC13008558
Est. Start Date
Est. Completion Date
Corporate Customer
Relations
(866) 803.0079
cusm
EMAIL A n .
Ir�IA+s~]l
CALL SUP
ADORES
r 'f1 5
CrtYISTAT ZIP r
L 3
HOM HONE Z3 Z
CE4L P Q / !
b
WORK PHO E
OPTION 1
•' ■
OPTION
SIZE TYPEQl,
ETYPE ,
PE
ICIENCY1 r[
EFFI NCY
S s
v
c cJ $ js.l� ..
) k x$
RIENC
hmx
$ �"
$ rt✓
$
0
1 —
SUBTOTAL $
SUBTOTAL $
SUBTOTAL/ $
MONTHLYEST.' $ ��
MONTH EST.` $
MONTHLYEST.' $
CUSTOMER INITIALS _.
CU5 MER INITIALS
CUSTOMER INITIALS
Warranty." Parts 4)!=R— Labor
arranty;" I f) Parts ;7-^SL_ l abop
Warranty:" (C- Parts c:)� Labor
Compressor Heat Exchange
_LCompressor Heat Exchanger
-LO-Compressor Heat Exchanger
*Subject to credit approval. Financing Provided by Gmensky. Fixed interest rate of 6.99% for 60 months. Payment example assumes one-time $7,600 purchase on
approval date (APR 7.1991) w Ih
1 payment 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 9.99% for 84 months. Payment example assumes one-time $7,500 purchase 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 Acfivalion charge of $39 applies and is due wtlh
first required payment. Fixed interest rase of 9.99% for 120 months Payment example assumes one -lime $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 payment Fixed interest We of 9.99% for 144 months. Payment example assumes one -lime $7500 purchase on approval date 1APR 10.09%) with
1 payment of $101.44. 5 payments of $62.44. and 138 amortized payments of $91.62. Payments assume Accounl 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 ❑ Dehum-difier
SUBTOTAL $ SOo
Disconnect ❑ Ceiling Saver Kit ❑ Outdoor Unit Pad
ifetime Equipment Slab (Pan & Float) ❑ Flue Venting
ir{$ 3 �00
and Isolation Pads ❑ Main Drain Safety Switch �uctwork Connections'
- j
❑ Liquid Tte Conduit ❑ Seal New Connections ❑ Cannecl to existing plenum
$ 00
❑ Start Kit ❑ Support Altic Equipment ❑ Duct Modifications
§ItfrigerantLLDryer_,) RupplyPlenum (seelVosrofor scope ofwaW
e
TOTAL $— �(�•�
FF'Refrigerant Pipe ❑ NewtiReconnect ❑ New Duct System
❑ New IERoconnecl )EWelurrl Plenum o Duct Work
❑ Refrigerant Pipe Cover ❑ New �Meconnect Fuel Piping
❑ Expansion Valvah ❑ Electronic Air Cleaner ❑ Electrical Wiring
Xx atat-Type SST ❑ Media Filter ❑ Home Service Plan -
❑ CASH ❑ CHECK# .
fimonnect to Existing ❑ PCO 1 Term (354 days)
❑ CREDIT CARD (LAST 44s)
Eiectr cal ❑ UV Light X
[AINew Plywood Deck ❑ Humidifier
_
EXP _ APPROVALOUR
GUARANTEES
FINANCING"
Comfort Guarantee Home Protection Guarantee
24•Hour Service Guarantee 00% UncondTonal Money -Back Guarantee
NOTES
CARS is not responsiVe for preex'st;ng ductwork. See Terms and Conditions on the back of this document for details,
• Written customer authorization w;: 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 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 righL
• 1 acknowledge that my right to cancel has been explained to me orally and in writing, and withoul waiving my fight 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 ft to protect your legal rights. This home improvement contract may contain a mortgage or otherwise create a lien on your property
that uld be foreclosed od�not pay. Be sure you understand all provision c tract before you sign.
CUSTOMER SIGNATURE BATE PANY REPR TAfti
CUSTOMER SIGNATURE DATE DAT
C 2019 Amerimn Residential Smices LLC. All rights reserved. ARS1078 FL 19n124 L100124 8256
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: 201778778 Date: 07-12-2019 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) : 24APB660A'030'
Indoor Unit Model Number (Evaporator and/or Air Handler) : FV4CNBO06L
Region : All (AK, AL, AR, AZ. CA, CO, CT, DC, DE, FL, GA, HI, ID, 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, SD, TN, TX, UT, VA, 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 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-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 57000
SEER: 16.00
EER (A2) - Single or High Stage (95F) :13.00
t'Active" Model Status are those that an AHRI Certification Program Participant Is currently producing AND selling or offering for sale; OR new models that are being
marketed but are not yet being produced.'Production Slopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Ratings that accompaniedarby WAS indicate an involuntary re -rate The new oublished ratino is shown alono 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 an this Certificate. Certified ratings are valid only for models and configurations listed In the
directory at www.ahridtrectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary 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, A=
personal and confidential reference. AIR•CONamONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The Information far the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we wake lire 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 132074077724712111
g, g g CERTIFICATE NO.:
Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved.
Site Address:
Parcel ID:
Account #:
Map ID:
Use Type:
Zoning:
City/County:
Ownership
Gary L Ralston
Pauline Ralston
3450 Twin Lakes TER Apt 204
Fort Pierce, FL 34951
Property Identification
3450 TWIN LAKES TER 204
1327-704-0034-000-5
130221
13 : 27S
0400
Legal Description
LAKESHORE VILLAGE OF MEADOWOOD PHASE I BLDG 3003 UNIT
204 (OR 3830-2842)
Current Values
Just/Market Value:
$121,000
Assessed Value:
$105,060
Exemptions:
$50,000
Taxable Value:
$55,060
Property taxes are subject to change upon
change of ownership.
• Past taxes are not n reliable projection of future taxes.
• The sale of a property will prompt the removal of all
exemptions, assessment caps, and special classifications.
Taxes for this parcel: SLC Tax Collectoe's Office
Download TRIM for this parcel: Download PDF
Saint Lucie County
Total Areas
Finished/Under Air (SF): 2,238
Gross Sketched Area (SF): 2,741
Land Size (acres): 0.02
Land Size (SF): 1.000
All information is believed to be correct at this time, but is subject to change and is provided without any warranty.
v ! Copyright 2019 Saint Lucie County Property Appraiser. All rights reserved.