HomeMy WebLinkAboutBuilding Permit ApplicationALL APP(LIICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: tJ Permit Number:
ti 7 J 7
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenge, Fort Pierce Fr! 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
Property Tax ID lt: Lot N
Site Plan Name: Block
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with )ton, SEER, KW AC unit
CONSTRUCTION INFORMATION:
rtiuunwnai worK to ne errormea anger erns permit— cnecx all rn apply:
VAC Gas Tank Gas Piping _ Shutters Windows/Doors
U
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction: $ �l� Utilities:[]Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Dennis Zacek
Addle s:
Company: AIRS American Residential Services
City: I I Stater
Address: 2800 US Hwy 1
Zip Code. 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 I if different
E-Mail:
from the Owner listed above)
State or County License: CMC1249753
it value or construction Is �ocsuu or more, a 14MU MIJ Ivotice or Commencement is required.
SUPPLEMENTAL CONSTRUCTION,LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
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.
ti Jeh•h:�
Signature of O er/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF 51Lude
The f g inst as acknowledge efore me
this day of r by
Dennis Zacek
ai n ackn wiedging j
ature of of ic- tate of Florida }
Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF Sl Lurie
The for ng instr t was acknowledg d fore me
this Zday of 20 Elby
Denns Zacek
(Na f erson ackn led 'ng
(Signa ure of Not y Public- State of Florida j
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No.
Revised 07/15/2014
COLEEN SULLIVAN
EXPIRES February 09.2021
No (Seal)
My COMMISSION # GG071&
EXPIRES February 09. 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Certificate of Product Retinas
AHRI Certified Reference Number; 9481127 Dale: 10-28-2019 Model Status: Active
AHRI Type: RCU-A-CB
Series: 14 SEER AC
Outdoor Unit Brand Name: PAYNE HEATING AND COOLING
Outdoor Unit Model Number (Condenser or Single Package) : PA14NCO24"0"A'
Indoor Unit Model Number (Evaporator and/or Air Handler) : FB4CNF024L
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 Juno 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 PAYNE HEATING AND COOLING product Is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of ANSI/AHRI 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), btuh : 22800
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.50
t"Active" Model Sfalus are those that an AI IRl Corti'k;ation Program Partidpa-I is currently producing AND selling or offering for sale; OR new models that are being
marketed but are not yet being produced'Productlon Stopped' Model Status are those that an AHRI Certification Program Participant Is no longer producing BUT Is still
selling or offering for solo.
Rafings Ihe,
are accompanied by WAS indicate an invr. untary re -rate. The now pub"shed rating is shown along with the previous Mo. WAS) rdtina.
DISCLAIMER
AHRI does not endorse the praduct(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 produet(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.ahrldirectory.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 uIlIzed, in any form or manner or by any means, except for the user's Individual, A=
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.ahridIre ctory.org, click on 'Verify Certificate' link we mike lire Ueuer-
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.-
02019A1r-Conditioning, Heating, and Refrigeration institute CERTIFICATE NO.: 1321677OD662116103