HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/06/2021 Permit Number:
DIS
•o J
L' • la� L: �ri a
Building Permit Application
Planning and Development Services
Budding and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:HVAC / Mechanical
PROPOSED IMPROVEMENT LOCATION:
X
Address: 10 ISABELLA LN PORT ST LUCIE, FL 34952
Property Tax ID #: MOBILE HOME PARK Lot No.
Site Plan Name: 10 ISABELLA LN Block No.
Project Name: MARIA ARISTUV
["DETAILED DESCRIPTION OF WORK:
Exact AC change out, no duct work
2.5 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: $ 8,407 Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name MARIA ARISTUV
Name: Dennis Zacek
Address: 10 ISABELLA LN
Company: ARS / Rescue Rooter
City: PORT ST LUCIE State: FL
Address: 2800 U S HWY 1
Zip Code: 34952 Fax:
City: Vero Beach State:FL
Phone No. 772-361-4311
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 $7,500 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 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 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 commencing work or recording your Notice of Commencement.
C)Z�_- i
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor .nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscr:bed before me of
X Physical Presence or Online Notarization X Physical Prese ce or Online Notarization
this day of 20' by this (a day of VA 20 by
DENNIS ZACEK DENNIS ZACEK
' Name of person making statement. j Name of person making statement. I
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary ,Iftih1DAGILLIS
.... k,.: MY COMMISSION # HH 045659
Commission No.+,; ` EXPIRES: September 23, 2024
';'Z6! fyQ.= Bonded Thru Notry Public UndarwrRet:
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
Personally Known X
Type of Identification
{Signature of
Commission No.
OR Produced Identification
hate of FIVjWXbAGILLIS
MY COMMISSION # HH 045659
,os EXPIRES: September 23, 2024
Bonded Thru Notary Public Undermiters
SUPERVISOR I PLANS I VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
� r
k Making d right*
Making it ~'or '
Installation Work Order
(772 )567-3100
2600 US Highway 1, Vero Beach, FL 32960
American Residential Services of Florida, Inc.
License # CMC1240753, CAC 1813963, EC13008558
Eat. Start Date mac-f —2 A
Est. Completion Dale QID(c-iliLt
custOM£R ^ t gr+'� '"'
CALL SUP
ADDRESS GTYMATEIZIP
15P1(3EL_L.
Lo
----.i�
HOME PHONE CELL PHONE _
2`
WORK PHONE
OPTION 1 OPTION 2
OPTION
SIZE PE
SIZE _TYPE
TYPE
SIZE TYPE
EFFICIE CY � C 4 syc
EFFICIENC k 01EFFICIENCYI
L4 .SeGC;�',xsuotiK
$ _[
'. $
NCLl71�t rJi.tJ
$
$
((Dues.-k�oRrl
_Q1 $
'5CXX
SUBTOTAL
SUBTOTAL 35
SUBTOTAL $
MONTHLY E ,• $, _a
MONTHLY ST.- $ _ grJ
MONTHLY EST.'
CUSTOM INITIALS
CUSTO R INITIALS
Werra lyParts Labor
CUSTOMER INITIALS
Warranty:Parts Labor
""
Warran :' Paris Labor
Compressor Heat Exchanger
Compressor Hea Exchanger
1�Compressor,�Heat Exchanger
as o1herwiae noted, al wanamfies are horn the mandacturor.
• •
SELECTED OPTION: ❑ 1 ❑ 2 93
Weatherproof l Reconnect Drain Line ❑ Dehumidifier
SUBTOTAL $ -
Disconnect ❑ Ceiling Saver Kit ❑ OuldDor Unit Pad
Lifetime Equipment Slab (Pan & Float) ❑ Flue Venting
$
Sound Isolation Pads Gd Main Drain Safety Switch ❑ Ductwork Connections'
35 J.-StmW411
Liquid Tite Conduit ti Seal New Connections ❑ Connect to existing plenum
_ _$
❑ Start Kit L� Support Attic Equipment ❑ Duct Modifications
911401
1
_
fill Rofrigerant LL Dryer �j Supply Plenum 1 fne Won for =Pe d wow
TOTAL $ _ _
Q5 Refrigerant Pipe M New ❑ Reconnect It➢ New Duct System
❑ New IS Reconnect d Return Plenum ❑ No Duct Work
❑ Refrigerant Pipe Cover Irk Now ❑ Reconnect ❑ Fuel Piping
❑ CASH ❑ CHECK# _ _
❑ Expansion Valve ❑ Electronic Air Cleaner _ ❑ Electrical Wring
T•stat —Type 14M ❑ Media Filter ❑ PROS Club Membership
❑ CREDIT CARD (LAST 4#s) _
Connect to Existing ❑ PCO — 1 Term (364 days)
EXP —APPROVAL
Electrical ❑ UV Light — G
[
❑ New Plywood Deck ❑ Humidifier _
FINANCING
• • • NTEES
'L=nspin..tse by Eme&*usA M..9w FDIC,on
eppraed cede kw a rented w a Eaw wW mend* rnN,w,1a baaad w 5.99% w 9.99% J.W APR
Comfort GuaranteeHorne Protection Guarantee
Guarantee
' mm% depwiding m kw amixi L.Ir.e' wcol ba t.zoM
P4pm,, w Wm* .ary eom 381* 144 mamba W wnim ban
24•Hour Service Guarantee 1009b Unconditional MonerBack
r,w,etla apple DO.ar knanoN opw, m" be walihim
NOTES
Ntiw 17vCCtA * `(T�tl11�YIV .S) AIL "
fo V�. INTZR€.ST 0r1e,
N�STTHf_stw►osT No 0600 Qce(MEIX,
4-i0AR'.u4NE STPADS
f�l:-U0E.tzr'l%Rr.Spox lNcwDt� lor Nv
COSTS
F_LF_crR1c 1-i AT
Z
Ip vp Sv6,TE►.AI,_'1aTzaA1Q" Nzk.2' cA9Lcs\Ca(202-t) VALY lla9tp"%
Z-91`1 W trt Z1r VCNT'S (INuA.Vi4t. PcatA%T)
'Company is not responsible for preexisting ductwork See Terms and Conditions on the back of this document for details.
• Written customer authorization win be obtained before beginning any unforeseen additional or extended work
• ANY CLAIMS FOR CONSTRUCTION DEFECTS AR E SUBJ Ear TO THE NOTICE AND CURE PROVISIONS OF CHAPTER 55(, FLORIDA STATUTES.
• BUYER'S RUGHTTO CANCEL: This Is a home solicitation sale, and If you do not waat the goods orservices, you may cancel this agreement
by providing written notice to the sailer in person, by telegram, or by mail. This notice must indicate that you 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. If you cancel this
agreement, the seller may not keep all or part of any cash down payment. See the reverse side hereof for an explanation of this right.
• I acknowledge that my right to cancel has been explained to mo orally and in writing, and without waiving my right to cancel, I authorize the performance
of the work, subject to all terms and conditions set forth on the reverse side her col, plus any taxes upon completion.
Notke To Owner • Do not sign this home Improvement contract in blank. You are entitled to a copy of the contract at the time you sign.
Keep It to protect your legal rights. This home improvement contract may contain a mortgage or otherwise create a Ilan on your property
float could be foreclos d on If you do not pay. Be sure
_you
_understand all provisions of the contract before you sign.
t�tvrJ��1tJEA --
C OMER SIGNATURE E ' COM 1W RE $ENIFIIVE
CRZ) !�59 - (7 (off `� =
020021 Amx� n-1..,,,,,,i s�L.L.G MARS1078_11 210210 1.2110210 C{��I # 8256
Certificate of Product Ratings
AHRI Certified Reference Number; 202717625 Date: 07-06-2021 Model Status: Active
AHRI Type: SP-A (Single -Package Air -Conditioner, Air -Cooled)
Outdoor Unit Brand Name. CARRIER
Outdoor Unit Model Number (Condenser or Single Package) : 50ZPD030***3***
Region : All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS,
MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S.
Territories)
Region Note: Central air condit oners manufactured prior to January 1, 2015 are eligible to be installed in all regions
unBl June 30, 2016. Beginning July 1. 2016 central air conditioners can only be installed in region(s) for
which they meet the regional efficiency requirement.
The manufacturer of this CARRIER product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHRI 210/240 with Addendum 1, Performance Rating of Unitary Air -Conditioning
& Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 28600
SEER: 14,00
EER (A2) - Single or High Stage (95F) : 11.50
t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being
marketed but are not yet being produeed."Production Stopped` Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
setling or offering for sale.
Rat nas That or, acoomoartipd by WA$ inoiw'e an involunlo-v re -rats. Thu new Dualished raii-)q is shown alona with tho crov:aus ti.e. WA51 rail-io.
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 product(s), 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.ahrldirectory.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,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & 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 heiter"
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.: 132700736568191605