HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: cl a -z' D Permit Number:
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: c
Legal Description:
Property Tax ID #: � �� _� . �` Ot I LP - Q 0 0 -3_ Lot No.-
5 it e Plan Name: Day lb--��n Block N
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1
Replace AC, exact change out with ton, 121 SEER, 10 KW AC unit
LC0— INFORMATION:
Additional work to orme under this permit -check a apply:
L/>VAC f Gas Tank ❑Gas Piping Shutters Q
_ Windows/Doors
11 Electric 0 Plumbing Sprinklers 1 [ Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor:
G
Cost of Construction: $ L�+ O UtilitiestSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
' Name 1�=.. -
Name: Dennis Zacek
�
Address: o j 1�5
Company: ARS American Residential Services
City: 1 State:
Address: 2800 US Hwy 1
Zip Code: Fax.
City: Vero Beach State: FL
Phone No. -7-7'cz�9 -
Zip Code: 32960 Fax,
E-Mail:
Phone No -I -Ya_ -7 (1 - -13[)%
Fill in fee simple Title Holder on next page (if different
E-Mai�r1 u I iva.(�5'
from the 07er listed above)
State or Count{ License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City: State:
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 our Notice of Commencement.
Qh�►ti...�
s
_
_ Signature of O er/ Lessee/Agent
Signature of Contra r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF s«e
COUNTY OF s«uce
The forgoing instrument was acknowledgedI ore me
The forgoing instrument was acknowledged before me
A)
this day of Zo _X y
thisd! day of r , 20 by
Dennis Zacek
Dennis Zacek
a
of person ackn i
( p rson acknaleing I%'n
(
_
J ( )OA
rgn a of Nat P ic-State of Flo da j
otaryorida
Personally Known x OR Produced Identification.
Personally Known x OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission NdEIL1 0c_ (Seal)
Commission No. � (Seal)
Cr)l FEN SULLIVAN
- Ix"itk -; COLEEN SULLIVAN
t1Y G0::1A4i55'i3ir' '= GGO 71535
Revised 07/15/2014 EXPIRES F�irruary 09, 202- +'
'i i`,1Y COtAPAi b
'';,� 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 Ratin
AHRI Certified Reference Number: 7490506 Dole: 01-28-2020 Model Status: Active
AHRI Type: SP-A
Series: R410A AC SPP
Outdoor Unit Brand Name: CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 50ZPC042-30"
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, ND, 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 AHRI 2101240 with Addendum 1, Performance Rating of Unftary Air -Conditioning
& Air -Source Heal Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), bluff : 41ODD
SEER : 14.50
EER (A2) - Single or High Stage (95F) :11.50
1'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 Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is s0
selling or offering for sale.
Ratings that are accompanied by WAS Indicate an Involuntary re -rate. The new published rating is shown along with the orwous fl.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 arising out of the use or performance of the prpductis), 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.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 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, -AM
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION A REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better`
and enter the AHRI Certified Reference Number end the date on which the certificate was Issued,
which Is listed above, and the Certificate No., which Is listed at bottom rlghL
02020Air-Conditioning, Heating, and Refrigeration Institute 1 CERTIFICATE NO.: 132247018116028071