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HomeMy WebLinkAboutSUBMITTED PAPERS�WE ❑ Electrical ❑ Shed Fee Due: Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Plumbing ❑ Demolition Seepage 2 for instructions and 1. Location/Site Address,: 3 M� 2. Parcel ID Number: FSHVAC ❑ Fence ❑ Gas ❑ Siding paperwork require! for specialty kermits Permit �,, v s Sce��E� Uhl® C©UntY Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. ColnRletd Descriptiongf Project or Work: LIKE FOR LIKE CHANGE OUT 4:"ow Name: Address: City: - State: t" I Zip: `336( Phone: nQ­ 6. Value of Construction: $ 01-A0 � 5. Contractors Information FL Reg/Cert #: CAC016446 County Cert#: 8283 Business Name: SEA COAST AIR CONDITIONIG Phone:772-466-2411E®x: 772-466-3053 OWNER'S AFFIDAVIT: I certify that all of the information contained in this compliance with all applicable laws regulating con: ,JQFN V T,ANr.PT. PRINT OWNER OR CONTRACTOR NAME SIGNATURE STATE OF FLORIDA, COUNTY OF ST . L�UCIE ACKNOWLEDGED BEFORE ME THIS DAY JITLO 20 WHO IS PERSONAL4 KNOWN TO ME X OR HAS PRODUG AS IDENTIFICATIO TRACY LANGEL NOTARY PUBLIC RA _Y LANCET,' OTAYE OF FLORIDA SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY Gomm# EF.02i97.4 COMMISSION NUMBER E 21914 t 9 Expires 8/3012014 that all work will be done in BYJOHN V LANGEL 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 $7500.00 N Revised 04/26/2010 AHRI Certified Reference Number: 4635467 Date: 5/30/2013 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: GPC1448H41AC 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 2101240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: F Ratings followed by an asterisk (7 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 forthe model cited on this certificate can be verified atwwwahridirectoryorg, lop,21 Air -Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date onME and andRefriterm on 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.: 130143897291304218