HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/26/2021 Permit Number:
55,7o LUCE:
U � W_�l Y Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:HVAC / Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 24 VILLA BLANCA FORT PIERCE, FL 34951
Property Tax ID #: MOBILE HOME PARK
Site Plan Name: 24 VILLA BLANCA
Project Name: RICHAARD WARD
DETAILED DESCRIPTION OF WORK:
Exact AC change out, no duct work
3 Ton, 14 Seer, 10 KW PACKAGE UNIT
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No._
Block No.
_Mechanical —Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric — Plumbing __.. Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 6,000
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
OWNER/LESSEE: I CONTRACTOR:
Name richard ward
Address: 24 villa blanca
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 216-262-5069
E-Mail:
Building Height:
Name: Dennis Zacek
Company: ARS / Rescue Rooter
Address: 2800 U S HWY 1
City: Vero Beach State. FL
Zip Code: 32960 Fax:
Phone No 772-794-7205
Fill in fee simple Title Holder on next page ( if different E-Mail mgillis@ars.com
j from the Owner listed above) j 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:
NER/ENGINEER: x
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: —State:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:_____
Zip:
Phone:
x Not Applicable I
I
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, wa!-s, 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 your Notice of Commencement.
_ Signature of Or/ Lessee/ARer: S+gnature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF s,L—o
The for sing instruy�ment was a cnowiedged before me
this day of A U 20 Aby
Dennis Zacek
(Name of person acknowledging )
M ALFJQ- �C�
(Signature o Nota Public- State of Florida )
STATE OF FLORIDA
COUNTY OF St Lucie
The forgoing instrument was acknowledged before me
this-ZLdayof u za Ll by
NJ
Dena, Zacek
(Name of person acknowled ing ) If
{Signature of No ry Public- State of Florida )
Personally Known x OR Produced Identification Persona!ly Known x OR Produced Identificat-on
I Type of Identification Produced Type of ldentificat.on Produced
Commission No. ommission No,
:;. MIRANDAGILLIS
MY('QMMIRS10N#HH d...-.,. r'i;. , ' MIRANDA GILLI
EXPIRES: September 23, 2024 =*: :• My COMMISSION # HH c45654
A.
Revised07/i5/2014 eondedrnn,Norafyauh*cundnrwriters ,.,.oP;.` EXPIRES: September23,2024
°F `.''' Bonded Thor Notary Public Underwilers
REVIEWS FRONT ZONING SLIPERVISnR PLANS VEGETATin SEA TL IRTLF I MANt;RnVF
COUNTER REVIEW I REVIEW I REVIEW REVIEW I REVIEW REVIEW
DATE
COMPLETE
INITIALS
Installation Work Order
RM.-in
SIX
Making it wortr
right'
(772 )567-3100
2800 US Highway 1, Vero Beach, FL 32960
American Residential Services of Flonda, Inc.
License # CMC1249753, CAC1813963, EC13008558
Est. Start Date ox
Est. Completion Dale w'lw
Cu
cnusue
Z4 WAN
HOME HONE .`
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CEIFij�i OCiO
WORK PHONE
SIZE TYPE — SC
SIZE S_TYPE SG
SIZE TYPE
EFFICIENCY 19 J(
EFFICIENCY I rc 5-,F Z
EFFICIENCY
$1 "O�
$ 411D
$
p
s $ Eft
$
is ��$
$
$
SUBTOTAL $ OOQ
SUBTOTAL $/,?5_
SUBTOTAL $
MONTHLY EST* $
MONTHLY EST.' $
MONTHLY EST' $
CUSTOMER INITI
CUSTOMER INITIALS
CUSTOMER INITIALS
Warranty:—Z4490arts 4X Labor
Warranty:'--`-"FtL Parts Zft Labor
Warranty: Parts Labor
mpressor eat Exchanger
Compressor -/ffaHeat Exchanger
Compressor Heat Exchanger
"Urd 6s ort :mw w noted. e9 w&nknries are from 1lro mWVSCturer.
SPECIFICS or •
SELECTED OPTION: 1 ❑ 2 ❑ 3
J
IT Weatherproof EMeconnect Drain Line ❑ Dehumidifier
SUBTOTAL $ �D
Disconnect ❑ Ceiling Saver Kit ❑ Outdoor Unit Pad
E (Wetime Equipment Slab (Pan & Float) ❑Flue Venting
$
UrSound Isolation Pads ErMain Drain Safety Switch Stuctwork Connections'
quid Tite Conduit Meal New Connections ❑ 9xviect to existing p6wn
$
❑ Start Kit Cl Support Attic Equipment Pbuct Modifications
@(Refrigerant L.L. Dryer___, girSupplyPlenum [MNot" rot KomofWOO
TOTAL $
17 hZefrigerant Pipe ❑ New (El"Reconnect ❑ New Duct System
❑ New ❑ Reconnect ❑ Return Plenum ❑ No Duct Work
Cd' efrigerant Pipe Cover ❑ New []Reconnect ❑ Fuel Piping
q CASH &61HECK#
Expansion Valve ❑ Electronic Air Cleaner ❑ Electrical Wiring
CT}"- scat --Type ❑ Media Filter ❑ PROS Club Membership
❑ CREDIT CARD {LAST 4#s1
❑ Connect to Existing ❑ PCO 1 Term (364 days)
EXP APPROVAL
Electrical ❑ UV Light
❑ FINANCING
❑ New Plywood Derck ❑ Humidifier
• UR GUARANTEESappwed
'loam p m ded by&m8"USA. Mw berF01C. on
uedl far a faded time Fsemmd m'anft
MR., prr,u,w based oe &N% or 992% rood APR
ImeAdepe =0nlo,rra m d.efecliwasofA01.2M
�/
L�i�iomfort Guarantee LrHome Protection Guarantee
E� l4-Hour Service Guarantee a 100% Unconditional Money -Back k Guarantee
is OUM r my W9 ap;; s" , �PM1
NOTES
'Company is not responsible for preexisting duawork. See Terms and Conditions on the back of th s doclment For deta.'s.
• Written customer authorization will be obtained before beginning any unforeseen additional or exterded work.
• ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJECTTO THE NOTICE AN D CURE PROVISIONS OF CHAPTER 558. FLORi DASTATUTES.
• BUYER'S RIGHTTO CANCEL: This is a ]tome solicitation sale, and if you do not wantthe goods or services, you may cancel this agreement
by providing written notice to the seller 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. It 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 me orally and in writing, and without waiving my right to cancel, I authorize the K enrman e
of the work, subject to all terms and conditions set forth on the reverse side hereof, plus any taxes upon completion.
Notice 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 lien on your property
that Id tLe forecloAdon if you do ay. Be sure you undo nd all provisio e co ct before you sign.
d) . 'O'k
USTOMeRSiGNATURE OA COMPANyV~EK—rA1nvE
L 2021 American Raikkmisi aardcaa LLC-N eol-nwnad, ARS1o76_FL_41D210 L210210 0256
Certificate of Product Ratinas
AHRI Certified Reference Number: 202717626 Date: 08-26-2021 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) : 50ZPDO36***3*'*
Region : Ali (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
untie 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 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 : 35000
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 bevrg produced."Production Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Rat,nim thW, are acQom1}ar+ed by 44AS indifia'e an irvglurLary ro-r$te. T,ne new gubli#hed rali'Sh is Sho„n1 Mona with L�10 orovious fi.a. WAS) raGna.
DISCLAIMER
AHRI does not endorse the product{s] bsted 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.ah►idirectory.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 reprodmed; 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, &9URI&I
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.ahridi►ectory.org, click on 'Verify Certificate' link %,e make lire hetter-
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 I CERTIFICATE NO.: 132744598788080990