HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dare: Via ZO Permit RumBer:
Building Permit Application
P1o..—: jj Q.,a Ucadt.......f 5,,
tsQ:10""g .,,a coa�
2500 V;, jj,— . AVc—c, tort Ku—FL J49tU I
PRoMe: (11L) 46L-1553 Fa.,: j//L} z[Bz-1$18 Commercial ResiEential
PERMIT APPLICA I IUN FOR: To Select fern dropbox, click arrow at Lhe end of line
PKUPU50 01311uyERIE19I Cul.AtIUIq:
A09re33:5"S10 ��VFv+� C �_ Vx �0({ P1&fCE , Fl 3y`&Z - - --
t:egal Description: In [Gln mvtv 1 Z6 L
Properly i ax ID N: _ ._ 0z5 Lot no.ZSo Vr 4,1
Site Plan Name: SIOCR no. G'5
Project Name: \t %.-; 15lmM klivi
Setbacks Front Back: Right aide: Eeft aide:
I DETAILED DESCRIP I ION UF WORK: I
Replace AC, e,.act Lhange gat with 3 ton, I SEER, KW AC ani#
CuMs I RuC I ION iICFURIVIA I Iuiv:
Additional work to be Dertormed under tis permit — Check all appy:
HVACSas , ank Das Piping _ �Rutters ❑ wintlo :sT0ov:3
Electric ❑ Plumbing Elaprinklers E Generator 0 Root Roor piton
Total Sq. Ft of Construction:
Cost or Construction: $A1 % Z
OWNER/LESSEE:
a Ft. or First Floor: _
utilities: Li Sewer E]Septic
Name Mk\G �tWm�+n►n __
address:
r iL�:5 t'.CTCtr State:
Lip Code: Z„ Fax:
Phone No. -TZ' W t- 45
E -Mail:
Fill in Tee simple i iilc Rollfor on newt t.a$e j it different
from the Owner listed about
Buildine Height:
CUM I RAL I uR:
Dame: De^nM croak
Cornp�nr: AKS American Residential Services
Address: 2800 US Hwy 1
City: vero lleacn Mate: FC
cip CoOe: JZVOU ran:
Pncne Ro.�
E -Mai �(rilm�`e Gimes
State or County Eicense: G� i��arb3
If value of construc%ion is $2300 or more, a RICURvED Notice or Commencement is required.
50PPCEI4+1EiVTAL CIINSTf�OCTiON VEIL I W INFOR F]IATION'
5 3IGNER/ERGIN-CER: x Mot mpplicable MORTGAGE COMPANY: X NOL Applicable
Name: Name:
Addre»: Addrebb:
City: SLaLC: City: SLaLe:
Zip: Phone: Zip: Phone:
FEE zJMPCE I I I CI~ FIOCDitn: x I-01 Applicable SONDI19G CORIPAIQY: x loot Applicable
Name: Name:
Address: Address:
City: City: -
cip: Mane: cip: PRORC:
I certify that no work or installation has commence'! prior to the issuance of a permit.
fit. Cwcie C--9 .I rm Ke- RV rep, C,C-T..tiCR rMI i, gr-Rti„s - pgmit will -arnar;.c tne—e,mit Fiola�r to Build tree ,e6;eet atrnctnre
which is in cvn�lict with any applicable home Owners Rssocladon rules, Bylaws or anXcovenants that may restrict or prohilsit such
structure. Please consult With you, Home Ow„ers Associat;o„ and review your deed for any restrictions which may apply.
In cVR311!lerotioR at the gr-Rtins of trii, re4ee3tea permit, 1 8o rler e6r ..gree tR..t I mill, in Gil rc3peet3, F.Crtarm tRr- w-rR
in accordance with the approved p'ans, the Florida Building Codes and St. Luce County Amendments.
Me following uuilding permit applications are exempt from unuergoing a full concurrency review: room alluuitions,
-cCe5,o. yy 3traCtare,,-37.:rRming povl3, tcncc'a, 7-113, 5iS-3, 3Creen rvC, ii and aCVeiRlM Q -e3 tv amutR.r nOn-rc3iUcmtwl 03C
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your Paying twice for
improvements to your property. A Motice of Commencement must be recortletl ana postea on the joasite
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 or Contra r/ [icense PlolCer
a I A I E OF FCOKIDA STATE OF FLORIDA
COUNTY OF St Lune COUNTY OF StL„as
e
i
I he forgoing in trument was acltnowleageh Qerore me Inc torsoins in „ent .a, -cRRo .leased sero, RMc
this s_ day of MQ U _ zo4LLby this � day of zv -CU by
Deniz Z -■■k Denn:s Zacek
(Name OT person acKno: lelaging) (Dame or person acitnowleuging ]
(Sir, a ti, C at Nvt-ry Pa61ic- state of Flovida'�-' e or Nota.-, Pehlic- state of FI ri j
Personally Known x OR Produced Identification Per,cR-Ily Koivwwn x OR Proaecea IcIentit;-ti-n
I ypC of 18entiti�-tion PreBeCei3 ', type or Irientiiicatior�n,yProouces
_
I CHf3W*UNEUF l
COmrRi33;vn A CemR1i„iQn ICo.�"L
State of Florida - Notary Public CHATE:AUNEUF
tMELISSA
Commission # GG 340178 _ - Nota Public
My Commission Expires may 3o, zuz3 �ommission it GG 340178tcevised
vii i�1LQ ni.,;, civ., Expires @lay au '.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
i
i
L
E=t. Start 0-te a :
Installation Work Order
Es;. Completion Date �/
1 . •. [//YJ56Y-3f OV
280D US High -ay 1, Vero Be -ch, FL 32960 C-rpor-te CLIStanler
-ork. Making Am.ri-.n R■.d•mtimI Servi=._ .f Florid Imo, Lieen:e Ir CMC 1249753, Relat.oil'.
Making i` EG;.oaae:,v 18661 8030679
cel -1!n I
`
EMAIL
.,eeneca
� CITYf t
P1a111! riven!
c Lt: pRefl!
WORK PHONfc
OPTION I
OPTION 2
OPTION
Si/E IYYE
SIZE
31zE I7PE
EFFICIENCY
EFFICIEN
EFFIC.IEICi.1'
SUBTOTAL $
5UBTOTAL 41.
SUBTOTAL $ i
MONTHLY EST.. $
MONTHLY EST." p
MONTHLY EST.'
CUSTOMER INITIALS
CU.aTw-MER INITIALS
C.05TvRIER INITIAL5
W ,feat$," Port,
Ca-Sor
Warren;y:" A ?Pens (na VlLabor
Warranty:- Parts � Labor
1 0-frrpre,.cer H. -t Exohanger
O tjompre33o05tJHea_i Ext changor
Compressor Meat Exchanger -
'..Ejocr ru crooii approval. r inanurig Pfuviueu by Greensky. Fried interest rata of 6.99,, f.r 60-•wlh■. P_; mr_ l wx.m l.-r_xm.: ane -time $7.500 purchase .n
approval d -.l. (APR 7.19' ) -ith
I ,-�mvmt e1$62.69, 5 pegme.,.e
of $43.6e, -fid 5+—m.rt,.d payin.m.C: v. $; ey.7_ raymenra aaaome .,ccwnl n flvalivn cnsrge or .vu9 applies and is due Oath
viral regeNea paymv, d.. Ixoo inrerool , ale ca 9.5111-11111h,r o, mvmns payment exp plc assumes one-time $7,500 purchase on., pr�l d_te (APR 10.15%) =th
5 payment of $101.44, 5 payments of $62.44, and 78 am-rtr=ed p pw■wlc _f $131 11. Pw wio ml: a-■rwe A-eenl Aeti-alien ch,.r9e of $39 appliv_rid re oec wi;n
Iire.y
l moluxed p.ment. Fixed inl■re= rete e1 9.99% for 120 mm.h... Aayme... e.amply uoaunfoa one•lima $:,3ve par. -6 a vn approval aaiie (nPR 50.51rN,) will,
; payrne.,f of $, , 9 paymevfa
yr $uz-,, anm ;;» amurareu payments nr.alv2 13. payments assume Accounl Aetrvali-n ch.lo■ •f $39 pplie- -.d r: d■w
wile first required paymenlTixed interest rat- .f 9.99',. for 144 nr•nih• P_,-mu_t ewe-tilme $7,500 purchase en-ppre-al d -.o (APR ; a.eo m) niirl
I pw, m,nt of $101.44, 5 potmen.o of $62.44, -rid 138 cmorr,.ed p..y..moela of $.m-, mz Psymenta aaaema r coovl r,orvalivn ...wrge vl 4.9 applies m,v is due
WhR ;ire; regelrev pay -on..
'•U.le-dhoruouv noted, a l —mmiee � fro.rr.he mmrel,„.lerer:
SPECIFICS
OF •UR INSTALLATION
SELECTED OPTION: ❑ ❑3
WWvotheppreef
Disconnect
ER..-mmro! Drain Line ❑ Dehumrador
Ceiling 3a -up Kit G Outdoor Unit Pas
SUBTOTAL $
/ �
litetlrne Egeip...ont 51.6
al�J.,,sound
(Pan & Float) ❑ Flur Vpming
_
j/irl'S �! �-91
`�
Isolation Pads
❑
Main DR.rn 5-fety S-1teh IJ Due: twork 1;onneetien„'
Liquid Tato Conduk
G Start Kit
eat New Connect ons )iLbonnect to existing Unum
$
efr g.—t L.L. DryA4
5epport Attie Egeipfnent El Deet Medif'ieetio_
apply Planum (sae Kn. stype pe ur work)
TVTAL $
�/,��
Refriger n,ty Pipe
❑ Ac- Revonne�i
0 Me.. � R2 o.mneot 0 Now Deet 5yctern
r'2
kRefrigerant Pipe lie-er
�eturn PI nurn Vlo Duct Work
Ne.. ❑ Feel Pipi-g
❑ Iff lmmvot
D Enpanolun Val.$
stat-Tpe
u Electronic Air � _Aeaner .. C Electrical Wiring❑CASH
❑Mediu Filter❑ Herne S�rrrce Plan -
❑ CHEvK# �lf fr r
L_r.nurT__E,I ting
Pvv _. i Term 1364 days?
❑ CREDIT CARD (LAST 4#oj A
nteav
Electrical
❑ Now Plyvvood Deck
__
❑ UV Light _
AA Q Cf
G Humiud er—
EXP`w ,PPR.VAL
OUR GUARANTEES
in FIMANC;ING'
El Comfort Goararrtue
❑ H�rrro Pretevtlen Gio-F-rites
❑ 24-Hver 5arrice Gaaranieo ❑ -, vD% Uncondilional Money -Back Guaranteu
NOTES
/,,r-64e/&q us.00./7y
Arlr7W, AAV
a -
'ARS b net responsible for pree.isii..g dnc,-vrk. See T ane and Cond4iuno vn the back of this doeo... ent for details.
• Written poutomer walhorirmium =11 be ub;alnvd before beginning wry enfor..con adai-,6nul ur a..ended work.
• ANY CLAIMS FOR CURSTRUCIION DEFECTS ARE 50B]ECT 10 THE NOTICE AND CORE PROVISIONS OF CHAPTER 558, FLORIDA STATUTES.
• BUYER'S RIGHT TO WCEL: Thb i -z - ho a-allcit-tion s.la, and It you do not wont the yvvas or aurnica., you may cancel this agree-
rrlant by pra-iaina -Fitton netiee to Me -cllwr In puman, By toleeram, or 6y -ail. This notice ,goat IndiWle that you do not want the goods
or Varrica7 ..ed meet bo dali:erda or poatm..rMiR 6efo.o midnight of the t6irtl 6oainu- day after you sign this agreement If you canoel
tit- agreement, tha seller ma, not Reap ..11 or port of any cosh dv,:rl p..Irmant. See iho rg:erse side hereof for an explanation of this rivfll.
• I .kn.-ledge th-t Ty fight for cancol has boon e;zplained io me orally end in Weiing, and fnnhum Waiving ...y right lv cancel, i aul..onze tim performance of
the -1-A cobjeet to all ten+la wad va-ditione cct forth on the rc-;--vide herb f, plea -.y lees upon cumplciran.
Notice To Owner • Do ..-.et -1g;; thic he:..o imprezaRlant aunt-ct In bl-.�k. Yom a 7� antltiiffl to a copy of the eontr.ct at the time you sign.
Keep it 10 protect your legal rights. This home Imprs a :est aentir-d may retain... mvrtg-go or UtfCrW13. mato a li-n an your property
of -t could bx: fercetooe I on if you do not pay. Ba .pure yv undorstwnd all pr ions of the contract before you sign.
5�
ells wf7l!•R al[snn70R6 DATE CO I'A 'EPRESEN7A71VE
ve.—m2R..re pX, DA
70 i l..rneriw, Re-.;[ tG:i services CCs, nil r,gns ,ewe . MSIO8 r[ 19012a L 19711 a 5256
� , v
Certificate of Product Ratings
ARRI Cartina8 Raters. -,w I9ern5er : 9543!18 Data : 05-05-2020 Model Status . Active
RRRI r ype : RCC-mZR
series : COIGIFOR i 14 AC
Cialawr Unit Brand Namc : CARRIER
vuWtoor 'unit MoCel MumDer (C;ontaenser or single Package) : z4AZ�_,w35M*Da9*
Intfo�r unit Moavi ICeirn0u, (E-.,peratvr ..nater Air I l-WIler) : F134CRFUj5E
Region : S.,atheast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, %R, oC, I M. s 7K, vm, Fin, w, %-IT, ID, I[,
IA, IA, Rs, MA. ME, MI, M19, MO, 1911, ICD, ICE, Arl, IQ.r, ICY, orf, OR, PA, RI, bD, 01, V 1, vvA, vvv, WI, WWY, U.b.
Territories)
Region Note: Central air conditioners manufactureu prior to ranuary r. zZ;15 are eligible to De instalreu in ail regions
aRtil jRNa sv, 4015. 60yinnirly lerl, 1, 2015 ecrrtr..l Jr avl7aitioFire con anly 5. im5tallea in rey;on(s) to.
wfficll they meet use reyionai errtciency requirement.
r Me mant7Pacturer or uds LRRr-IRR pru—uuct is responsiole for use rating of uds system combination.
Rated as follows in accordance with the latest eGition of AAuhmMIKl z r'v zwZ; wlur nutuentua r anti e, Penormanee Rating of Unluary
Air-Conaidoning & Airsoerae Heat Parnp E.,vipmant ..na uai�cct to rating ..cuor-a, 5, ARKI-ape„aorJa, independent. thiro Party testing:
Cooling Capacity (A2) - Sil tyle .,, RIaFi Stage (95F), btuh : 33000
ol_CR : I.;.0U
EER (AL) - bill=yla er Ri,M Stays (voF) : iz.00
Model Statin alb th-r-c that am AHRI Certification Program Punccip.nl is caRbnUy producing AND moll ng or offo,;ng f,r 3.6; OR new mooclz mat are Lloing
marketed bet are not ;et being produced.?Prodectium Stepped9 Madel Stoteo ..re lhooe that ..N AHRI C.rtifieatien Progr-m P-rticip-rlt is ny lorlgcr producing BUT is atill
selling or offering for sale.
r2 Ln. hat ar{s Qcomo@n ed by WAS inaiu4to ar involuntary re -'ate. The raw injbli5hed rating is shown abng with the nret, ous li o W A+(j ra'iosu.
DISCLAIMER
AHRI doe= Net ende.-a the plod eet(=) listed an this Certifie, to and rA«kca no rcpr.,-nt..tions,—rteetl.s yr gaaran-..as as w and assumes no rt ,p.m3i6iIiy Tor.
the productfsj listed on this Certificate. AHRI e.-pressl; disel.dNls .,11 liability for de ...gee of aN; kind ..ri=iNg out of the a..e e! parferRroNee of the prodeet(„), or She
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed In the
ohwivey at www.rRrlairoucury.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and
AMR!
�vn�luvrldal ror.runco parpuses. tae untents or this Certificate may not, in whole or In part, be reproduced; copied; disseminated;
entered hie- ce:..p :cr d..:ab_,o; ..r o.he, -low mIllLad, In any form or mann.. a. By any me4nz, a...cp, rur fllc aser's Inusvluaal,
paraenal and r_nfldentlaI referenee. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
Th. inform.don for .he mad.! cF d on .!lis vcrris...,� ,.an Do :erlre. ar awa,aAriolros.ory..rg, CIieR on "verlfy Certificate' link
and anter the AHRI Certified Refeft eo Number and the date oN .hl.h th. wriiflee:e :...s issued,
which is listed above, and the Certiflcate No., -hleh m li_t_d ..t bottom right.
VZO23AiMonti I loning, Reating, anti Rerrlgoratio,, Inzti[aty CERTIFICATE Ao.: IJLJJI�JOLV IOLOaririL
ANORLS CERTIFIED'
Certificate of Product Ratings
ARRI CertiTIA Rerorarica 13em6er ; 9b4:il15 Dot- : 05-05-2020 Moa-1 Status : Active
AHRI r ype : RCu-R-CE
Series : COMFORT 14 AL
Cluldeor Unit Brand N.me : CARRIER
Outuoor Unit IOloGel Mumuer jCon'aenser or single r-acRage) : zwnCuwa'ox*ir3'u*
lnffoor unit IOIotlel Aum6er (E-aporator anal yr Air R.mtll-r) : FERCMFvs6C
Reypvn 5votho.3l and North (AC, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, Tn, WK, RR, w, U i , IC, IL,
IA, IM, Rs, MA, Illle, 1911, MN. 1910, M 1, 190, AE, MFI. Mi. MT, OFl, OFT, PA. RI, sD, Eli, v i, vvA, vvv, vvl, vvr, U.s.
Terrilori-s)
Royion Note: Central air Gond tioners manufactured prior to January i, zv 151 are eliyiCle to l9e inswlleu in all reyions
until June 3u, z0i6. Begirt-ir1= jell, 1, 415eo.,tr.l air eem8it:omers tram -ml, So installed in rz;-,,iom(z) Tor
which they meet uie regionar eiriciency requirement.
The manufacturer of this CARRIER prwuct is responsil7le for uie raliny or this system comDlnation.
Rat.d as folLws in accordance with the latest edition of ANSIIAHRI 2101243 widl rZzienua i anu z, PeRormance Rat ny of unitary
Air-Con'ailloning d< Air-5ource Fieat Pomp Egaipme..t and VIII%oat to 141ir'15 -.Or-7,, 5, AmRI-zpem;i-red, imBopen8ont, tnira party testing:
Cooling Cal—clty (A2) - Sine- or Righ 5taee (95F), 6taff : 33000
SEER : r4.3v
EER (Az) - Single or Flign stage (a5F) : -tz.Uu
?'Asti-." Model Statin ore these th.t are AHRI Certifieeti.e Progr.-re P-McIpant i.; currently prodecirlg AND aulhng or afe, ing for sole; OR ne:. moaels mai ar. Daing
marketed but are not yet being produced.?Production Stoppa? Model Stataa Ura there that on AHRI Certifi.etien Progr�.m P-rtieipant r= no longer prode.ing BUT is still
Willing or offering for sale.
Ragin45 t w grec m n:ed by WAS ;- dicma an invoii., ntary r -ralo. The law Publi5hed ralirii is shcwnI n vnih the orevious fi e. WAS' rit n
DISCLAIMER
AHRI d_= nut endersw the p,edeet(r) 11-ted on thl„ Certifieat..nd makes ere repre=enu tlonz, .-_m titles or us :o, .ed a 3omes no responalbilky for,
the products) listed on this Certificate. AHRI expressly disclaims all liability for damagve of .n; kind ..riri;;g met of the are er p.rfe. manes of the prodeet(.;), or the
oneoiflurizeu alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
dlreo..ry ., awa..hrid Iroc:ory.org.
TERMS AND CONDITIONS
Mi. s Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and
..,fid.nd.l r.feron�e purpose,. -. avn¢ents.ii [Ars vertiarn.o meg n.t, in wmole or in part, be reproduced; copied; disseminated;
entered Int... eempat.r d.t.b.-.: or ether-i- atlll—d, In ...y form .r m.nner or by .my m....s, c—upF for -.Ile User's Inuiviunai,
personal and confidential r.f.r.n_e. AIR-CONDITIONING, HEATING,
CERTIrICW.E —.ERIMC,.71vR &REFRIGERATION INSTITUTE
.tieR for th. modol .F.ed on .his oe,dfio... c.n be verified a. www.uMriair.ctary.org, 0,111 un ':eriry oorelricaLu' IinR wr make life hetter"'the
AHRI Certified Rofertrnee Namber.nd the d.te en which the vertifie.te -.s 1»tled,
ted above, and the Certificate No., which is listed at bottom right. " "AIIK:onahlonIng,
Relaxing, anti inteTrlgeradon Insxkuxe f CERTIFICATE NO.. '�23�'oz.,�z�o��a
L