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MECH1410-0059-ApplicationCity of Parkland Building Permit Application www.cityofparkland.org Phone #: Contact Person: -7/�,S"4xl'aiI: ALL OF THE FOLLOWING MUST BE FILLED IN BY APPLICANT, ACCORDING TO F.S. 713.135 Master Permit Number 41 0 . OCe9 Business Address (/ gfr 0 , /) j 47/ ..J / Date Cityaa�4J State j%'(, Z`a)6515hone #9 -537 —''77 57 Property Owner's Namej7C/JQ //e Owner's Street Address ` (, C{? fi tA1 (0,47 PLsa City State Zip Phone # atretdra 32-?, �'ls = � c)-1 Company Name tr/4471`2dtV-(4:2-<' kt,c/C Construction Value 3 �O Engineer's Name Engineer's License # Phone # Architect's Name Architect's License # Job Site Address c/ % l! a) 10 / of: j ( Block G� Phone # Work Description: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of permit and that all work will be performed to meet the standards of all laws regulating construction in the City of Parkland, Florida. I understand that a separate permit may be secured for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, BOILERS, TANKS, AIR CONDITIONERS, ROOFING, SHUTTERS, ETC. 1 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCMENT 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 Contractor Notification E-mail: Print Name of Qualifier/Builder: License number: Signaturc of Qualifier:/ On this 6, da g;' / r ,2o pi< , before me, the undersigned No, ry Public t}t StIle of Florida, personally appeared eA.1 Lir'! e'r and whose name is subscribed to and within the,yistrument, and he he acknowledges that executed it. 7 NOTARY PUBLIC, TATE OF FLORIDA PRINTED NAME OF NOTARY PUBLIC tII,personally known to U Oath taken NOTARY PUBLIC SE OFFICE: Prucgd identification •' ,OathnotLtlm(firiE LiANN,iLOKIETL Notary Public - State of Honda • My Comm Expires Feb 6, 2017 Commission # EE 847816 ..." Bonded Through National Notary Assn 11 1 J 0 Application Approved By: Permit Officer Property Owner Notification E-mail: Print Name of Property Owner: \;`cam\\ -e ,000Th Owner's Address: Signaturo rt Owner his 4, day of , 0 /1,1 , before me, the undersigned Nota Publif of th Stat of FloOda, personally appeared 'C 7t eft 7 "ind whose name is subscribed to and within the; instrument, a he/sfie acknowledgfs the he she executed it. NOTARY PUBLIC, STATE OF FLORIDA e/C1'0/'e /C (14 4 C04et c V CLIC - S53 —(03- 633—() 9roduced identification PRINTED NAME OF NOTARY PUBLIC ❑ Personally known to me ❑ Oath taken NOTARY PUBLIC SEA OF OFFICE: Date: at nota, NE DIANNA LOKIETZ Notary Public - State of Florida ol My Comm. Expires Feb 6, 2017 " Commission # EE 847816 ' °�, Bonded Through National Notary Assn. City of Parkland Building Division 6600 University Drive Parkland, FL 33067 Phone 954-753-5447 Fax 954-753-8838 A/C & Mechanical Replacement Information This form and ARI Listing must accompany' each permit application for the replacement of Air Conditioning or Mechanical Equipment. Please supply a separate data sheet for each Unit being replaced. Contractor (d...4_Alt vt �E c �%lp Chc ermit Number Job Address ej (say 6 /7() (e..9-1 Lot 30 Block ( Subdivision / / / e Gcfcg lit% OL UNIT h� / "7 <0 IctA 30 Wt./ 3C, YES /NO\ YES J NO YES I NO YES NO/ YES N(� ************- ********* ********************** Package Unit / / Contractor Signature State License / DATA Manufacturer C.U. Model # A.H.U. Model # Package Unit Model # EER / SEER ARI Reference Number KW Heat Nominal Tons Max Fuse / Breaker Thermostat Smoke Detector Heat Recovery Modify Ducts Stand / Curb / Slab Change Disconnect Need L er F4r7srrection aneous Electric Broward County Certificate of Competency Application Approved by: Rev. 1/09 NEW UNIT /4/4(7144 30 l T G.,/'% 4. (o 7 9 D —runs 3() C'f`7,d YES f Oy YESO YES INO YES NO YES INOL YES NO L YES Cy Package Unit / / Date rim)" 11"2113.11 www.ahridirectory.org This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. Certificate of Product Ratings AHRI Certified Reference Number: 7426795 Date: 10/5/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM30 Indoor Unit Model Number: RH1T3617STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD; WEATHERKING Series name: 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-Conditiorin end Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: - Cooling Capacity (Btuh): 29000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 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 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.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 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, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which is listed at bottom right. `©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE we make life better' 130570002959381248 - Q'QQ �o GS o� �,a