Loading...
HomeMy WebLinkAboutSUBMITTED PAPERS05/29/2014 15:24 77246631053 SEACOAST AC PAGE 01 Date: I Fee Due: I Receipt* Permit 0' Flanning & Development Services SCq�NEO ,1, :fir J _ - Building & Code Regulations Division m.is 2300 Virginia Ave. CUCk? C n. ► Fort Pieree, FL 34982 CUl7ty (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ll Plumbing 0 Shed ❑ Demolition See page .2 for instmcii�on-y aan+d I. Location/Site Address: a I Ji( L1 II 2. Parcel ID Number: ❑ B.VAC ❑ Fence ❑ Gas ❑ Siding ^ ,% -% l n r.... for specialty permits Township Range Map Page Zoning Lnnd Use Initials Off CC U3e $Crtjbrt Only 3. Com 4.0 f rmati `( Name: Y1 Address: City: State• Zip: Phon . 6. Value of Construction: 3 ontractors Information FL Reg/Cert 4: County Cert#: Business'Name., Phone: l 'S AFMAVIT: .1 certify that all Of the information con,talaed in this applical , _c4pliance with all applicable laws regulating construction PRINT OWNER OR COtLW,CTORN, STATE OF FLORTDA, COUNTY OF ACKNowLED TED BEFORE ME THIS WH IS FR.SONALL 7 AS $ A SIGNAT • 0 N A Y COMMISSION � Fax,, SIGNATURE OF 0 OR CONMkC ft DAY OFVOED 20 B ^,,,_• CJ.R WHO H_ T'RA,CY LANQEA. NOTARY PU8UC 8TAT9 0F FLORl0A R�?liaro @t�lia0�� (seal) e NOTICE TO OWNER; FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT tN YOUR PAYING TWI.CL rOR IMPROVEMENTS TO YOUR P,ROrERTY. IF YOU 1NTZND TO OBTAIN FIN,ANC'XNG, CONSULT WITH YOUR LENDER OR AN ATTORN. Y BEFORE RWOJRDING YOUR NOTICE OF COMMENCEMENT. EXEMPT; A/C -HEAT REPLACEMENT WITH CONTRACT TJND1;R $7500.00 Reyltcd 04/26n010 05/29/2014 14:43 7724663�,F!7 SEACOAST AC - PAGE 02 _ Planning & Developtnent Services Building & Code Regulations Divigion �. 2300 Virginia Ave. ■. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY ]PERMIT APPLICATION Electrical CJ Plumbing Cl Shed Q Demolition Seepage 2 for instructions and X. • ,ocsttion/site A. 2. Parcel ID Num 3. Coml a Name: Address: City: Zip: ❑ HVAC Q Fence El Gas CI Siding Office Use Only Section Tomship Aange MAP FAge Zoning Land Use IAlt lAlS Description of Projeci: or Work: 6. Value of Constructiow 3 1 Contractors Information AA A W M Rcg/Cert#: —69-0011— County Cert#: _ Business Name: f LPhone• `J���J Fax: ZER'S AFFIDAVIT[ I certify that till of the information contained in this application is correct and that all work will be done in .` —g4pliance with all applicable laws regulating construction and zoning. PRINT OWNER OR COURACTOR N, STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE METHIS WH IS ERSONALL t AS A: SIGNAT 0 Y COMMISSION ITT5MBEK SICY'NATURE OF OWNER OR CONTRACTOR. DAY OF 20k BY J&n - A�e OR WHO HAS PWD 'fRa1+GY LANGEL MOTAFiV' PUBLIC VTAA 9 t)F FLoRODA (SC6l� TIXIMMMOVAM NOTICTPTOOWNVR: FAILURE, TO RECORD A NOTICE OF COMMENCEMENT M*Y RESULT M YOUR PAYTNG TWICE FOtt IMMOVEMENTS TO YOUR PROPERTY. .lP YOU INTEND TO OWfAJN IFINANCJNG, CONSULT WITH YOUR LENDER OR A II ATTORNEY 5>L><rORE RECORDING YOUR •NOTICE OF COMMENCEMENT. EXEMPT: A/C4MAT REPLACEMENT WTM CONTRACT UNDER $1500.00 Revised 04/2V201 0 05/29/2014 14:43 7724663053 SEACOAST AC PAGE 03 Certificate of Product Ratings AHRI Certified Reference Number; 5053527 Date; 5/2912014 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: WJA330000K**0A2 Manufacturer: GRANDAIRE Trade/Brand name; R410A AC SPP Series name: Manufacturer responsible for the rating of this system combination is GRANDAIRE Rated as follows In accordance with AHRI Standard 210/240.2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: 661ing Capacity`(Btuh): 284bd :.E.ER Rating (Cboll .9 • ' ::S.EEI7 .i��ting::(GotllingJ: `�;�;. •.13:2Li., � �:,.;�•� ��,;; • � �:,;.,....,,. ... . . FootNole 11-•rTb6AWI#i.213253:2011, 5151:2010 and 186 �o�2aa•d�it,red.l=lirtings:ar;, c�Pdillar� undit<Ir the 13elmei;ttietfiodiil�y�;¢Rt 6i',ratlrigs at':1~'ndltibn9 Of 150 Ratings followed by an astariax (") Indicate a voluntary r,frat9 of prOVIDualy pubiit:hed data, unless aeeortlpanled with a WA$. which Indicates an involuntary rerate DISCLAIMER AHRi does not endafac the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility tor, the product(,) listed on this CertifiCate. AHRI expressly disclaims ell liability for damages of any kind arising out of the use or performance of the product(,), or the unsuthorlsed alteration of data listed on this CertlFWAe, Certified ratings are valid only for mOgeld and conflgum,tiona listed In the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRi. This Certifieatc shell only be used for Individual, personal and eohndentlal referener purposes. The contehis of this Certificate Inay not, In whole ar in part, be reproduced; coplod; disseminated; entered Into a computer del' or otherwise utiliacd, In any form or manner or by any means, except for the user's Individual, AM personal and confidenual reference. AIR-CONCITIONING, HEATIND, CERTIFICATE VERIFICATION a WRIGMTroN INSTMnr The Information for the model Cltod on this certificate Can be verlFled at www.ehrldlraotory,org, click on 'Verify Certificate" link and enterthe AHRI Certified Roforence Number And the date on which the certificate was issued, we n,alcc fife better - which is listed above, and the Certificate No,. which Is tlsted at bottom right _. F ©2014 Air-conditioning, Heating, and Refrigeration Institute :; ' t' II ATE NO.: laoasa55739t339eaBe