HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential 1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: V
Address:
PropertyTaxlD#:�1G7 f3I,�6
Site Plan Name: sa ✓a ✓I f1l 6 Li�.i9� a:t -y/ /4tPP
Project Name:
New Electrical Meter Second Electrical
CONSTRUCTION INFORMATION:
Lot No. !_
Block No. C 0
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: $ t 0 Utilities: —Sewer _Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name !
Name:
Address:
company:
2.S
City: 4jorj -5it Nze; - State: �C_
Zip Code: 3!, �? Fax:
Phone No. n2j—gjj../ - 4%dR
Address: � t
City:% AVP
ZipCode:?5th9.!�-2— Fax:
Phone No/
State:�L
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Cd Pl�01XC4 .691
_ • g Agw
State or County Licensees 'l
o C$66 t?
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: -
Address:
City: State:_
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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 review your deed for any restrictions which may apply.
Inconsideration 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
Dr1.1 w�
Sign f Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA ��"�� ", �� /
COUNTYOF ✓ 64 P,
Sworn to (or affirmed) and subscribed before me of
Physical Presence r Online Notarization
this ,1_4Z day of rn u� 202# by
Nam o pe s n making statement.
Personally Known __k__/OR Produced Identification
Type of Identification
Prod` d f I ,,
(Signature of Notary Public- State of Florida )
A*IDRA
of Floridi
111 Ay>
Sig fY Contractor/License Holder
S rTE OF FLORIDA
COUNTYOF S:f I1-4/ j g (
Sworn to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
this _Z,�'day of202# by
�s,{-E A 1 M P �Li
Name of per on making statement.
Personally Known I/ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission
PLANS
REVIEW
Certificate of Product Ratinqs
AHRI Certified Reference Number: 7615303 Date: 05-25-2021 Model Status: Production Stopped
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Series: FRIGIDAIRE P7RE SERIES
Outdoor Unit Brand Name: FRIGIDAIRE
Outdoor Unit Model Number (Condenser or Single Package) : P7RE-046K
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, IA, MA, MO, ME, MI, MN, MO, MS,
MT, NC, ND, NE. NH, NJ, NM. W. 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 FRIGIDAIRE product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHRI 210t240 with Addendum 1, 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 : 47000
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.00
t"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.'Produmion Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Ratings that are accomoanied by WAS indicate an mvoluntary re -rate. The new Published retina is shown along with the previous (i.e. WAS) ratina
DISCLAIMER
AHRI don not endorse the product(s) listed On this Certificate and makes no representations, "mantles 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 productls). 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.ahridlfectory.ofg.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Indvidual. 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,
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.ahrldlrectory.org, click on'Verlfy Certificate" link ..x make life heneP'
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.
02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 3zss4zz4o924397a3
1578 Niemeyer Circle
Port St. Lucie, FL 34952
Clean ,fir
Technologies
PROPOSAL AND AGREEMENT
A/C Sales Service Installation
By Jeffrey Almeida - Lic # CA-0058660
CUSTOMER NAME 9r///
ADDRESS-3 2
CITY, STATE, ZIP q iT�cX
(772) 335-2061
Fax 335-1802
PHONE DATE
JOB ADDRESS
WORK PHONE
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on all pages
of this proposal.
EQUIPMENT SPECIFICATIONS
Make 'rrjg1A Model Number(s) ��✓ �' —� ��L�
SEER / EER 11 BTUH Cooling Waop BTUH Heating OV/07CFM
Installation shall
_New _Amp disconnect
New low voltage wiring
__ViVew reinforced equipment pad
_New vibration isolation pads
_New properly sized refrigerant lines
_New, clean, dry ACR copper tubing
_Charge to manufacturer's specs
_Insulate refrigerant suction lines
_Install refrigerant drier(s)
_Evacuate refrigerant system
V Remove existing equipment from premises
Install new-7..o I thermostat
_New copper wire from to
Complete system start up
X=Yes
ake air tight plenum transition
New dehumidistat
_New supply diffuser
_New duct run fromto
_New return air filter grill
_Noise reducing flexible duct connector
(Clean work area to customer's satisfaction
_New condensate drain system
_Install aux. condensate drain pan
_New high efficiency air filter
Meet all code requirements
0year parts warranty
year labor warranty
year compressor
>C _year service agreement
Option (below) _ Alternative (below) Is (= Is not) included in price
Terms: Installed Price
Taxes
Total Amount
Down Payment
lance Due
Date: S' L —,—
Terms and Conditions
1. All orders not paid in full in advance are subject to approval by the Company's credit department.
2. This proposal may be withdrawn by the Company if not accepted within 30 days.
3. The Company shall provide only trained and qualified technicians employed or supervised by us.
4. All labor is to be performed during Company's regular working hours, unless noted in this proposal.
5. Warranty work is performed during Company's normal business hours, but can be performed after
normal hours if Customer pays the difference between standard labor rate and overtime labor rate.
6. Until final payment is made, the Company will retain the title to all materials and equipment it installs.
7. Unless noted in this proposal, payment is due in full upon completion of work. A monthly finance
charge, equal to the highest allowable interest rate, may be levied on Customer's account if delinquent
over 30 days.
8. In the event Customer's account must be referred to attorneys for collection, Customer agrees to pay
reasonable attorney fees.
9. Customer will carry fire, extended coverage and other necessary insurance.
10. Customer shall assume risk of loss or damage to equipment after it is set in place on the job.
11. Every attempt will be made to complete the work on the date(s) specified, but because the Company may
have no control over equipment availability and delivery, all completion dates are estimates only.
12. The Company shall not be liable for damage, loss or delays resulting from fire, explosion, flooding, the
elements, labor troubles, or any other cause beyond our control.
13. The Company shall use ordinary care in performing all work, but shall not be liable for incidental or
consequential damages, or shall it be liable for injuries to persons or damage to property except those
directly caused by negligent acts of the Company's employees.
14. The Company shall not be responsible for any damages incurred due to inability of the building structure
to properly support the installed equipment, or for expense incurred in removing, replacing or refinishing
part of the building structure necessary for the performance of any service or installation, unless otherwise
noted in this proposal.
15. The Company shall not be liable for any present and future taxes, charges or other government fees, or
any items of equipment, labor or special tests required or recommended by insurance companies,
equipment vendors or governmental authorities.
16. The Company shall not be liable for the identification, detection, abatement, encapsulation, storage,
removal or transportation of any regulated or hazardous substances. Regulated or hazardous substances
may include, but are not limited to asbestos, certain refrigerants and refrigerant oils. If any such products
or material are encountered during the course of work, the Company can discontinue work until regulated
or hazardous materials have been removed or hazard or liability eliminated. The Company shall receive
and extension equal to the time of delay to complete the work an reserves the right to be compensated for
any loss due to a delay.
17. This agreement contains the entire understanding between the Company and the Customer, any
modifications, amendments or changes must be in writing and signed by both patties.
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