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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LUC[
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: /:-/V4�u
PROPOSED IMPROVEMENT LOCATION:
Address: -30ak Gti'%Pt)�[he�i��1f
Property Tax ID#:_3gyS — 7DS-0/2�-0,722—Lot No. biz
Site Plan Name: _gall n4la [.%(/ e,6a g, 7 YeB. Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
J S
r7
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
r—/,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: $ ,5:3 ?0 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name VV�&
Name:
Address:
Company: %%//
city:.4w2Qcr 4/' r /!L!.[G State: AG
Address: S o
City: State:ocz
Zip Code: 30&Z. Fax:
Phone No. 2'Q�3 5:�
Zip Co : =347L Fax:
E-Mail:
Phone No
FIII in fee simple Title Holder on next page (If different
E-Mail. ICiV� 42
State or County Ucense 64— l' al if
from the owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is S7,500 or more, 3 RECORDED Notice of Commencement is required.
Y.h.Y fy�_xja.; 1•a .�aE W'. s^` a.Jt x
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name'
Address:
Address:
City:
Zip: Phone
State:_
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
JNotApplicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City -
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFF1Dv1T: 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.
�. �.._._„_.._...__t,_._..----e+h�*i�.ono.Jrwill aurhnrizethe cermitholder tobuild the subjectstructure
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 thelobsite before the first inspection. If you intend to obtain financing, consult
.. �_:__,. _,,..., ..�t<..� rernrAina vrn,r Notice of Commencement.
W411 luiluu�ccl wjall mw'.�ucu/c/. aJ,.c r.,, ............ ....
grla'i net/ Lessee/Contractor as Agent for Owner
Sig tractor/License Holder
[STATEOF FLORIDA
STATE OF FLORIDA
OUNTYOF1 Ar J
COUNTY OF_
wom to (or affirmed) and subscribed before me of
sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
202J by
tha,�dayof�02� by
this day of
��& Al
)�
Name ofp on ma ng statement.
Name1�
making statement.
Known Produced identification
Personally Known OR Produced Identification _
Personally _JZ-011
Type of identification
Type of Identification
Prd
Qe�n
Produ etl
(Signature of Notary Public- state of Florida)
(Stgnature of Notary Public- state of Florida t
Commissio
W LSH
commission NOLSH
'%State of Florida•Notary Public
��a•�';;�.-57C!t'DRA
:State of Florida -Notary Public
_ = am tsston
REVIEWS %;, `T My n Z§tiPi R OR
- yy Commission xplies
SEPAIMRTILE20 &IANGR VE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.7/b/tU
1578 Niemeyer Circle
Port St. Lucie, FL 34952
Clean ,fir
Techncicales
PROPOSAL AND AGREEMENT
A/C Sales Service Installation
By Jeffrey Almeida - Lic # CA-0058660
•
ADDRESS W
CITY, STATE,
(772) 335-2061
Fax 335-1802
PHONE 0.��-H< 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 /_ /)6 /A 10 Model Number(s) P 7A t c, 4 )
SEER lq EER BTUH Cooling BTUH Heating -f0 CFM
Installation shall
include: Mto�
101
New _Amp disconnect
New low voltage wiring
_New 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 refrigeran system
Remove existing wpment from premises
_Install new ZVXY thermostat
New copper wire rom tc
Complete system start up
Option (below) Alternative (below)
Terms:
EN
X =Yes
_Make air tight plenum transition
_New dehumidistat
_New supply diffuser
_New duct run from to
_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
Me t all code requirements
year parts warranty �a
3 oft_year labor warranty
ear compressor
year service agreement
Is (_ Is not) included in price
Installed Price
Taxes
Total Amount
Down Payment
lance Due
Date:
Terms and Conditions
1. All orders not paid in full in advance are subject to approval by the Company's credit department. O
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.
S
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 O
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 parties.
C
Certificate of Product Ratings
AHRI Certified Reference Number, 7615294 Date: 12-20-2021 Model Status : Active
AHRI Type : SP-A (Single -Package Air -Conditioner, Air -Cooled)
Series: FRIGIDAIRE P71RE SERIES
Outdoor Unit Brand Name : FRIGIDAIRE
Outdoor Unit Model Number (Condenser or Single Package) : P7RE-042K
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, INC, NO, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SO, 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 2101240 - 2017 with Addendum 1, Performance Rating of Unitary
Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third parry testing:
Cooling Capacity (A2) - Single or High Stage (95F), btuh : 40500
SEER: 14.00
EER (A2) - Single or High Stage (95F) : 11.00
}'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.'Producton Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still
selling or offering for sale.
Retinas that are accompanied by WAS indicate an involuntary re -rate. The new published retina is shown alonb with the previous (i.e. WAS) ratlno.
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 products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the producl(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.ahridirectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Intlividual, 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, Rim
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION A REFRIGERATION INSTITUTE
The Information forme model cited on this certificate can be verlfled at www.ahtidirectory.org, click on 'Verify Certificate' link „r "„k, hfI In,ii"
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.
©2021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1321544934366534539