HomeMy WebLinkAboutbuilding Permit ApplicationALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Alm
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 1 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential JCS
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED
Address: C2'3c�)
Property Tax ID #:
Site Plan Nami
Project Name:
Setbacks
Front Back: Right Side: Left Side:
Replace AC, exact change out withd'12ton,
SEER, KW AC unit
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit — check
ec a apply: In
HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers 0 Generator O Roof Root pitch
Total Sq. Ft of Construction: IIll
Cost of Construction: $ ( !J.
tv
S . Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: Dennis Zacek
Addr s: r V
Company: AIRS American Residential Services
City: State: FL
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 (if different
E-Mail:
from the Owner listed above)
State or County License: CMC1249753
it value of construction is 5Z5ofl or more, a RECOWED 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 Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF St Lucie
The f oing instr nt wa acknowledge efore me
this day of 20 acknowledged-before
annis Zacak
{ a of person a owledgin
g ture of Nota u ic- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission Nc� (Seat)
T COLECN SULLIVAN
MY COMMISSION # GG0715:
Revised 07/15/2014 ' ,;,� EXPIRES February 09, 2021
STATE OF FLORIDA
COUNTY OF St Luce
The fgrgoing inst ment was acknowledg�efore me
this day of 20 by
Zacek
of
�e of`h6tary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
_n... .. r%r%i CC
MY COMMISSION # GG071535
EXPIRES February 09, 2021
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INITIALS
Certificate of Product Ratings
AHRI Certified Reference Number: 203022944 Date: 12-03-2019 Model Status: Active
AHRI Type: RCU-A-CB
Series: COMFORT 14 AC
Outdoor Unit Brand Nome: CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 24ACC430A'030'
Indoor Unit Model Number (Evaporator and/or Air Handier) : CNPV'3017AL'
Furnace Model Number: 58S(B,C)'A045E17"12
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, NO, 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 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 ANSIIAHRI 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), bluh : 27400
SEER: 14.00
EER (A2) - Single or High Stage (95F) :11.50
t"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'ProducUon Stopped' Model Status are those that an AHRI Certification Program Participant Is no longer producing BUT Is still
selling or ofiedng far sale.
Relings that are fmaompanled by WAS indicate an Involuntary re -rate, The new published retina is shown alono with the previous (i.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 liability for damages of any kind arlStng 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 configuratlons listed In the
directory at www.ahridirectory.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 pert, 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 6 REFRIGERATION INST1TtrTE
The Information for the model cited on this certificate can be verified at www.ahvidirectory.org, click on'Verify Certificate' link wr make life 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 CERTIFICATE NO.: 132198693748559026