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HomeMy WebLinkAboutSUBMITTED PAPERS/ o Date: "Fee Due: Recei t# �s'mit # Planning & Development Services y Building & Code Regulations Division SC 2300 Virginia Ave. A Fort Pierce, FL 34982 (772)462-1553 ucie C04h f Y SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing E HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: L-7 -rw"'v ( -do zed, & 2. Parcel ID Number: `a . e_ / �r UPC-- ��^ /3See/r IComplete Description of Project or Work: liM fo ow —LI 4. Owners Information 5. Contractors Information Name: R& FL Reg/Cert #: C ACO S't81 0 Address: 3 County Cert#: 7 �t 27 6 State: �L Business Name: Cui— om A t f SSS city: Polt;�s�d�! o e f£t'M S IN C Zip: 6 4?&Z Phone: S15--440 'Od"' Phone: 77133S 323a Fax: 77A 331- 1468• 6. Value of Construction: $ oWNER's AFFIDAVIT' I certify that all of the information contained in this application is correct and that all work will be done in compliance with all applicable laws regulating con n an on CU.t'T0S Si mrA ow-- PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ST L U r-1 a ACKNOWLEDGED BEFORE ME THIS ( DAY OF J , 20 /V BY " ,'MAZO12-f— WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. / rVA ;Bl% CHRISIINE B. ENGLI3H S / MY (MISSION # EE 859284 SIGNATURE OF TARY /O� TYPE OR PRINT NAME OF ARY EXPIRES: April 4,2017 ��i•��j�(OL' Q! �Oev Bonded Thm Budpe(Nohry Savleeb COMM[SSION NUMBER V? `/ NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER S7500.00 Revised 04/26/2010 CertifiedAHRI Reference Number:1 Date: • 1 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: PA3ZNB036000AB** Manufacturer: BRYANT HEATING AND COOLING SYSTEMS A/1,•I Trade/Brand name: BRYANT �� ll CO Series name: Ay Manufacturer responsible for the rating of this system combination is BRYANT HEATING AND COOLING SYSTEMS Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 34800 EER Rating (Cooling): 11.50 SEER Rating (Cooling): 13.50 IEER Rating (Cooling): ' Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibilityfor, 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.ahridirectory.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 forthe user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, fir-Gondifiioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on A' Refrigeration nditining, Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130334914516110270