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HomeMy WebLinkAboutSUBMITTED PAPERSDate: Fee Due: Permit # Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding St. Seepage 2 for instructions and additional paperw�ffla 'for ecialty permits Location/Site Address: C� ��L 2. Parcel ID Number: SC YNE �U�ie COU17ty Township Range Map Page Zoning Land Use Initials Office Use Section Only 3. Vlta 4: Ownerj� Igf(o�r[m�a{t-ion. ���,�G��-�, �nla� j. Contractors Information Name:Y�-C,I�I�VI iC�j QReg/Cert Address:- 1 m( County Cert#: City:- lcca State: Bust ess Name: Zip: CnJ Phone: " Ta Phon '. 6. Value of Construction: SL Fax: 5V aN o' AFFID VIT: I certify that all of the information contained in this appl' tion s c e d that all work will be done in J •\ compl ante with all applicable laws regulating constru z in PRINT OWNER OR CONT CTOR NAN SIGNAT F OWNE CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF ZO BY V !� 0 IS PER TO ME `�OR WHO HAS PRODUCED DENTIFICA `4F �� � 1p ATURE 0 N AR TYPE OR PRINTA NOF N 4RY p' ' .6M 'ST CO ON � MBER tfdC 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 57500.00 Revised 04/26/2010 a a a- � •a � � ,. ;t �-� 'p.. a � n:- ,tea nP. � r,s aa�� �•ID � � i '�~'� � � � k �.°� AHRI Certified Reference Number: 5677879 Date: 9/8/2013 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: GPC1330H41C* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN, JANITROL, AMANA DISTINCTIONS, EVERREST, ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 28600 EER Rating: (Cooling): 1100 SEER-Rating(Cooling)­ •1:3:00 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 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.ahridirectoryorg. 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.ahridirectory.org, Air -Conditioning, Heating, click on "Verify Certificate" link and enterthe AHRI Certified Reference Number and the date on IWffi U and 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 CERTIFICATE NO.: 130231312248754985 1 Planning & Development Services Building & Code Regulations Envision 3300 Virginia Ave. Fort Pierce, FL 34982 (773)443,15S3 i SPECIALTY PERMIT APPLICATION ❑ Electricail ❑ Plumbing ❑ RVAC ❑ .Fence ❑ Shed 11 Demolition 0 Gas ❑ Siding Sec'P4,e 3 for insiruerfons and addifianal papperwork requ •red for eiairV per,7d1$ L Locat5n/Size Address: ` c1�CQ r� u_ ?. Parcel ID Number: 3t-8 ^%. r w o, s 4• Ow11e formation 5. gontraelurs Inf4r atiojjV_ 5r, Name: ���'�% I Item/Cent: address: t i County Como; City: State: Busi ess ;flame: �^ -A Zip. Phone-" Qf Phan Fax. b. Value Of Constr ion: S s r • �� A Ut e J1. Acom pl ancc with all applicable laws regulating tonstru tr Ziin VV -P PRINT OWNER OR CONT . CTOR NAiv S[GN�TL F OWNL" ffcONTR.ACTOk STATE OF FLORIDA. COLN'rY OF ACKNOWLEDOEO BEFORE ME "HIS DAY OF _tla gy IOIS PER' T0,ME ��R WHO HAS PRODUCED � DGNTIF!C � ''0 WO �.�ult ka' ,j ATIJRL• U N ;�R r TYPE OR PRINT NAb - CF N RY A �JA NOTICE TO O WNE R: F.AlLURE TO RECORD A No,ricE OF COMMENCtMENT :►'IAY RE$UL'f IN YOUrk PAYING TWICE Flit IMP1kOVEM9iVrS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FTNANCING. CONSULT WITH YO1jl4 LENDER OR AN ATTOMEY BEFORE RECORDiNC YOUR NOTICE OF CONIMENCL'NIENT. LXEMPT! A!C-HEAT REPLACEMENT WITH CONT14AC"T UNDER S7500.00 Revitwd 04 26i20'111 ZO 39Vd Od 1Sd0Od3S 690699VUL bV:TT EZOZ/80/60 it i uuuvw,ahridirestory.org C 6F ,ertificat"� •Product Ratin! AHRI Certified Reference Number: 5677879 Date: 9/8/2013 Product: Single -Package Air -Conditioner, Air -Cooled Modal Number: GPC1330H41C; ManuMcturer: GOODMAN MANUFACTURING CO., LP. Trade/grand name: GOODMAN, JANI TROL, AMANA DISTINCTIONS, EVERREST, ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. Rated as follows in accordance with AHRI Standard 2101240.2008 for Unitary Air-Conditloning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third parttr testing: Cooling Capacity (Btuh): 28600 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13,00 • Ratings IvRowod by an asterisk (') indicate a voluntary rerate of prevlvu.ly pubs shed data, antes, accompanled with a WAS. which Indicates an Inygluntary rerste. DISCLAIMER -- AHRI dorm not endorea the product(s) listed on this Cartiflcata and makes no repnssontadons, warrmhtios or guarantees as to, and assumes no respunsibirity for, the produut(s) llstad on this Certificate. AHRI expresety disclaims all liability for damegos of any hind arls,ng out ofthe use or performance ofthe product(,), orthe unauthod:wd alteration of date listed on this Certiflcate. Certtlled ratings are valid only for modals and eenflpu►at(ons Rated In the directory atwww ahridirectoryorg. TERMS AND CONDITIONS This Cortilicata and Its contonte are proprietary products of AHRI. This Certificate ahetl only be used for individual, personal and r4rdidentl31 reference pumozas The contents of this Certificate may not, Ih whole or In part, be reproduced• copied; disseminatod; entered Into a computer database; orothehviso ubllzed, in any form or manner or by any means, except farths user's Individual, personal and confidentlal roference. CERTIFICATE VERIFICATION The information forthe model cilod on this cortitleate can be verified at wywrahridlrectory ors, � "IMP, Air-Canditioning, Heating, click on "Verify Certificate" link and enterthe AHRI Certified Reference Number and the date an � �� r� and Refrigeration Institute the aertifloate was issued, which is listed above, and the Certificate No., which Is Itatdd below. @2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130231312248754985 60 30bd Od 1Sd0Od3S E90E99VZLL VV:TT EZOZ/80/60