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HomeMy WebLinkAboutSUBMITTED PAPERSM Date: Fee Due: Permit # Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION • Electrical E3 Plumbing HVAC 13 Fence • Slued E3 Demolition 1:3 Gas 1:3 Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: -740 N& -W.A R L A - 2. Parcel ID Number: L-t Saz --SG I,. — O q L1 G —0 De) — G OJftce U e Only -Section Township Range Map Page Zoning Land Use Initials , 3. Comple a Description of Project or Work: i-SAM-46301k AC� l�dnG r Olr'J 4. Owners Information nn 5. Contractors Information D Name: pa� FL Iteg/Cert #: of-A--CGti$ z,.Ig--3 Address: N,6 A/-e 4Vkr- d v ri , County Cert#: City: State:t Zip: 3L19 S -7 Phone: ",S- 2'Lq _-70CJPhone: $%d -t1 S, - ?A 97 Fax: S_61— d6 i4 — 00 i. (l -.6. _Value of Construction: $ 3 3 —7 S, oe 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 re gu c struction and zoning. Maw / V� Ar,� �-- ,�-l%- PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS ZI/ DAY OF 7, anc /1/l 20 , BY s ✓ WHO IS PERSONALLr7O ME / OR WHO HAS PRODUCED uB zo a��; ••••'�o * MY COMMISSION # DD 949997 EXPIRES: May 5, 2014 s, oP Budget Nola Services (seal) ARY TYPE OR PRINT i AI,V OF NOTARY COPYINUSSION NUMBER NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT NIAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANI ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 . Revised 04/26/2010 �ir�,��`t4'rn'-• rt �VtbVtGV�f`3iLl'fdPr�GY.Rr Rt",# s�,e€�Kx ":aaa�'a�`��v,�t ,� r„�.,x4���7,.�% 4,a ,•t';' s'i�`...9 e`3` AHRI Certified Reference Number: 1076037 Date: 1/17/2014 Product: Year -Round Single -Package Air -Conditioner, Air -Cooled Model Number: RSNM-AO30JK Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD Series name: p - Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC. Rated as -follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source u Neat Pump Equipmentand subject to verification of rating accuracy by AHRI-sponsored, independent, third party. testing: Cooling Capacitl (Btuh): 28800 EER Rating (Cooling): 11.50 SEER Ratingi(Coolin . =1300 IEER Rating (,Cooling): <- a Ratings followed by an asterisk (7 indicate a voluntary rerate of previously published data, unless accompanied with a IMAS, which indicates an involuntary rerate. DISCLAIMER 4 d AHRI does not endorse the product(s).listed on this Certificate and makes no representations, warranties or guarantees as to, andassumes 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 wwvxahridirectory.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. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectoryorg, %RAWAir-Ccnditicning, Hecting, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on cnd Refrigeration 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 CERTOCATE NO.: 130344582409308098