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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1/4/2 02 1 Permit Number: I . FLUME "Pita Building Permit Application Planning and Development 5ervices Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34981 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR:HVAC / Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 5109 EAGLE DR FORT PIERCE, FL 34951 PropertyTaXID#: 1 31 2-801- 0 0 5 7 - 0 0 0 - 4 Site Plan Name: 5109 EAGLE DR Project Name: DANIEL KLIPSTINE—_ Lot No. 254 Block No DETAILED DESCRIPTION OF WORK: _ J Exact AC change out, sawkilillasNO pdcjt,4� r- dE0 Q 4y-) , c Mom 4 Ton, 14 Seer, 10 KW New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: _Mechanical —Gas Tank —Gas Piping — Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 9,236 Utilities: —Sewer _Septic Building Height: OWNERAESSEE: CONTRACTOR: Name DANIEL KLIPSTINE Name: Dennis Zacek Address: 5109 EAGLE DR Company: ARS 1 Rescue Rooter City: FORT PIERCE State: FL Address: 2800 U S HWY 1 Zip Code: 34951 Fax: City: Vero Beach State: FL Prone No. 772-766-6053 Zip Code: 32960 Fax: E-Mail: Phone No 772-794-7205 Fill in fee simple Title Holder on next page (if different E-Mail mgillis@ars.com from the Owner listed above) State or County License CMC1249753 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,SQ0 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: _ Address: City: State: _ City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 nevi ew 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencine work or recording your Notice of Commencement. r _0 Signature of Owner Less ` g / / ontractor as Agent for Owner Signature of Contractor/L' e e Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ST LUCIE COUNTY OF ST LUCIE Sworn to (or affirmed) and subscribed before me of S%`grn to (or affirmed) and subscribed before me of _X _ Physical Presence or Online Notarization �• Physical Presence or Online Notarization this W day of 207-1 by this ti day of � %%Ljcx.c U T, 20Ztby DENNIS ZACEK DENNIS ZACK Name of person making statement. Name of person making statement. Personally Known X OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- gnature ofNotary Public MIRANDAGILL#S Commission No. JJH oa5659= • :, MycofygrpS"INH MIRANDAGILLIS mission No. HH 045659 MyC OMMISSION # HH 045 3. F FxPfRE3: r oar`,• 23,;p: EftPIRE8: September 23, 21 • os REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW RECEIVED DATE COMPLETED Installation Work Order Eel. start Date 1 (772J567 3104 Est. Completion Dale l- = 281>0 U5 Highway 1, Vero t3eacl>, FL 329t30 Corporate Customer American Rp.w i al Scrvbes of fbrhla, hie LJceme a CMC1249T53, Relations CAC 181396a FC 13DM58 (866) 803.0870 CUSTOMER EMhK CALL SUP AVORESS C! !STATUzr 4r q 151 t"' HOME PHONE ELL CPWNE WO' Ric aHQNE OPTIONOPTION .•. SIZE _ TYPE S TYPE 1) IZE TYPE EFFICIENCY L4 SggC EFFIC CY SAC- �V v EFFICIENCY Nov. $ %g _Ga►- 00— $ S geiltrt- $'— M M—�'D� � SUBTOTAL $ 9e 7. 1o_ , SUBTOTAL � O, ZSO SUBTOTAL $� MONTHLY EST.- $_ _ 3/0H0 MONTH ST.• SAAo _ MONTHLY EST.' $— CUSTOMER INITIALS CUST ER INITIALS CUSTOMER INITIALS Warranty:" t— Parts On# - je— Labor W anty:"- , Farts _01F Labor Warranty:"— _ Parts Labor Compressor Heat Exchanger ol Compressor AeHem Eu or Compressor Heat Exchanger "Unfeea othen"se noted or wamintm are ham the arunu(mit•nr. • • SELECTED OPTION: 011 02 ❑3 ;dWeatherproof gReccinnect Dra n Line ❑ Dehumidifier SUBTOTAL $ _ Disconnect ❑ Ceiling Saver Kit ❑ Outdoor Unit Pad 1ff. Lifetime Equipment Slab (Pan Q Float) ❑ Flue Venting $ Sound Isolation Pads $Mau, Drain Safcty Switch ❑ Ductwork Connections' jffLiqufd Tite Conduit OScal New Conan., tons ❑ Connect to existing Pkxltrm $ ❑ Start Kit ❑ Support Attic Equipment J0 Duct Modifications f ❑ Refrgerant LL Dryer ZlSupply Plenum I+o• W" Ion Seeps of wodo TOTAL $ �Q j7Refngeranl Pipe ❑ New JgReconnect ❑ New Duct System Mew Eff Reconnect © Return Plenum ❑ No Duct Work O Refrigerant Pipe Cover ❑ Now ❑ Reconnect ❑ Fuel Piping ❑ CASH ❑ CHECK# ❑ Expansion Valve ❑ Electronic Air Cleaner _ fZT•statfMSM ❑ Media Filter _ ❑ Electrical Wiring ❑ Home Serwco Plan - ❑ CREDIT CARD (LAST 4A►s) FrConnExisting ❑ PCO 1 Term (364 days) EXPAPPROVAL Elect ❑ UV Light OFINANCING % CC 'New d Deck ❑ Humidifier 'Lew PbT Ewrear{ k% Mends aw, • Oak man amoM pparwd aaetlii � a l.Med Yma aOanrA•d hlf F Paymee+e based on 6.9M or 902% f+od APR 19Comfort Guarantee Iff Home Protection Guarantee Win i—Wt aftCOM he COAM 1. 20M RepW— iemu wry ham 36 to 144 m.&. M4 ban �J24•Hour Service Guarantee 0100%Unconditional MoneyBadk Guarantee .mar,tie.�y orwu.bnogopdnannyu�a o�eei. • fJf�R7.� Luc*Wol��, 2. Mp e �' �*M.AtST NEst --tir," wmwt INLLvbSA 00ru- %,s.?•4 ND WMEW F'2.Q.S ADD T) 'ARS a not responsible for preexisting ductwork. See Terms and Condifam on Ihs bads of this document for details. • t46itlen euslonier authorization will be obtained before beginning any unforeseen additional or exfanded work. • ANY MAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECT TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 558, FLORIDA STATUTES. • BUYER'S RIGW TO CANCEL: This is a home solicitation sale, and If you do not want the goods or service% you may cancel this agree- ment by providing written notice to the seller in person, by telegram, or by mall. This notice must Indicate that yos 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 B you cancel this agreement, the seller matt not steep all or part of any cash down payment See the reverse side hereof for an explanatiom of this right. • I adirowledge that my right to cancel has been etplaned to me orak and in writing. and without warvmg n8'right to cancel. I authorize the performance of the work, subject to ay terms and conditwns set forth on the reverse side horeol, plus any [axes upon completion. Notice To Owner . Do not sign this home Improvement contract in blank. You are onlitfed to a copy of the contract at the time you sign. Keep It to prated your legal rights. This home Improvement contract may contain a mortgage or otherwise create a Ilan on your property tlra could be foreclosed b you do not pay. Be sure you understand ati provisions of the contract before you sign. CUSTOMER SI NATURE DATE gWPANY REPRESENTATIVE 1- � Z. 539 - 6 �� �� CUSTOMER 64MATURE DATE O ZMAm•Ae•n Ra•idoaqii 6ervkn LLG Ar rights nssnsd. ARSIM FL 200a22 LMN22 "So