hvac matching equipment certificationcms5.revize.com/revize/eustisfl/develop services/ac changeout...

4
• Telephone: (352) 483-5462 • Fax: (352) 589-2651 • E-Mail: [email protected] • URL: http://www.eustis.org HVAC MATCHING EQUIPMENT CERTIFICATION Astatula, Clermont, Eustis, Fruitland Park, Howey in the Hills, Groveland, Lady Lake, Lake County, Leesburg, Mascotte, Minneola, Montverde, Mount Dora, Tavares, Umatilla This form shall be part of all mechanical permit applications for unit replacement. Permits will not be processed without supporting documents. The 2017 (6 th Edition) Florida Energy Conservation Code requires “At the time of the total replacement of HVAC Evaporators and condensing unit, all accessible (a minimum of 30 inches clearance) joints and seams in the air distribution system shall be inspected and sealed where needed using reinforced mastic or code approved equivalent and shall include a signed certification by the contractor that is attached to the air handler unit stipulating that this work has been accomplished. Exceptions: 1. Ducts in conditioned space. 2. Joints or seams that are already sealed with fabric and mastic. 3. If system is tested and repaired as necessary. 101.4.7.1.2 Replacement equipment sizing (mandatory). An A/C contractor or licensed Florida PE shall submit a nationally recognized method based sizing calculation to the code official at the time of permit application for total replacement of the condensing and evaporator components of HVAC systems in accordance with Florida law and the provisions of Section 403.6.1 or Section 503.2.1, as applicable. Installing both the Air Handler and Condenser Provide equipment sizing analysis with permit application. Provide certification of visual duct inspection at final inspection. The 2017 (6 th Edition) Florida Energy Conservation Code requires Outdoor and indoor units that are not designed to be operated together must meet the U.S. Department of Energy certification requirements contained in Section 403.6.2.1.1. Matched systems are required; this match may be verified by any one of the following means: Installing either the Air Handler or Condenser (provide documentation) The replacement unit you are installing is certified for capacity and efficiency by (check one): ARI RatingARL or other recognized testing laboratory Mechanical Engineer, Florida registration number____________________________ Manufacturer's letter License Holder (print name)______________________________ License #_________________ License Holder (signature)_______________________________Date_________________

Upload: others

Post on 16-Aug-2020

2 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: HVAC MATCHING EQUIPMENT CERTIFICATIONcms5.revize.com/revize/eustisfl/Develop Services/AC Changeout Per… · of HVAC Evaporators and condensing unit, all accessible (a minimum of

• Telephone: (352) 483-5462 • Fax: (352) 589-2651 • E-Mail: [email protected]

• URL: http://www.eustis.org

HVAC MATCHING EQUIPMENT CERTIFICATION

Astatula, Clermont, Eustis, Fruitland Park, Howey in the Hills, Groveland, Lady Lake, Lake County, Leesburg, Mascotte, Minneola, Montverde, Mount Dora, Tavares, Umatilla

This form shall be part of all mechanical permit applications for unit replacement. Permits will not be processed without supporting documents.

The 2017 (6th Edition) Florida Energy Conservation Code requires “At the time of the total replacementof HVAC Evaporators and condensing unit, all accessible (a minimum of 30 inches clearance) joints and seams in the air distribution system shall be inspected and sealed where needed using reinforced mastic or code approved equivalent and shall include a signed certification by the contractor that is attached to the air handler unit stipulating that this work has been accomplished. Exceptions:

1. Ducts in conditioned space.2. Joints or seams that are already sealed with fabric and mastic.3. If system is tested and repaired as necessary.

101.4.7.1.2 Replacement equipment sizing (mandatory). An A/C contractor or licensed Florida PE shall submit a nationally recognized method based sizing calculation to the code official at the time of permit application for total replacement of the condensing and evaporator components of HVAC systems in accordance with Florida law and the provisions of Section 403.6.1 or Section 503.2.1, as applicable.

Installing both the Air Handler and CondenserProvide equipment sizing analysis with permit application.Provide certification of visual duct inspection at final inspection.

The 2017 (6th Edition) Florida Energy Conservation Code requires Outdoor and indoor units that arenot designed to be operated together must meet the U.S. Department of Energy certification requirements contained in Section 403.6.2.1.1. Matched systems are required; this match may be verified by any one of the following means:

Installing either the Air Handler or Condenser (provide documentation)The replacement unit you are installing is certified for capacity andefficiency by (check one):

ARI RatingARL or other recognized testing laboratory Mechanical Engineer, Florida registration number____________________________ Manufacturer's letter

License Holder (print name)______________________________ License #_________________

License Holder (signature)_______________________________Date_________________

Page 2: HVAC MATCHING EQUIPMENT CERTIFICATIONcms5.revize.com/revize/eustisfl/Develop Services/AC Changeout Per… · of HVAC Evaporators and condensing unit, all accessible (a minimum of

Permit Application Form – May 2018 Permit # ________________________

CITY OF EUSTIS -- BUILDING PERMIT APPLICATION 111 E. Orange Avenue, P. O. Drawer 68, Eustis, FL 32727-0068

Telephone: 352-483-5462---Fax: 352-589-2651

Code in Effect: FLORIDA BUILDING CODE 2017, 6th Edition

Property Owner _______________________________ Contractor(Applicant)_________________________________ Address_______________________________________ License Holder________________________________________ City _________________________________________ License Number_______________________________________ State _______________________ Zip______________ Address______________________________________________ Phone ______________________Fax ______________ City _________________________State____Zip ____________

Phone __________________________ Fax_________________ E-mail Address: _______________________________________

Project Address____________________________________________________ ___________________________ Alt. Key #Subdivision_______________________________________ Phase_____________ Blk_________ Lot___________

Responding to a Code Violation? _______Yes _______No Within a Historic District? _______Yes _______No Is property in a Floodplain? _______Yes _______ No

Contract Price/Value: $_____________________ Proposed Project Description/Scope: ___________________________ _______________________________________________________________________________________________________

_______________________________________________________________________________________________________

It is agreed that in all respects the work will be performed & completed in accordance with the permitted and applicable codes of the local jurisdiction. This permit may be revoked at any time upon violation of any of the provisions of said laws, ordinances, or rules & regulations, or upon any unauthorized change in the original approved plans. This permit becomes invalid if an inspection for permanent construction is not requested within 180 days or more than 6 months has elapsed between inspections.

WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.

NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other government entities, such as water management districts, state agencies, or federal agencies.

I certify that, per Chapter 469, F.S., Asbestos Abatement, I will contact FDEP and provide the Notice of Asbestos Renovation or Demolition Form, and will comply with all requirements, including, but not limited to, conducting a thorough asbestos inspection prior to the commencement of demolition or renovation.

I DO HEREBY SWEAR THAT THE INFORMATION CONTAINED HEREIN AND THE ATTACHMENTS HERETO ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

SIGNATURE (Contractor/Applicant) ______________________________________________ DATE __________________

STATE OF FLORIDA COUNTY OF LAKE The foregoing instrument was acknowledged before me this ___________day of ______________________20_____________by _________________________________________________________________________, who is personally known to me or who has produced__________________________________________________________________________as identification.

__________________________________________________ Notary Public

If "Yes" Base flood elevation must be provided on your Site Plan.

Page 3: HVAC MATCHING EQUIPMENT CERTIFICATIONcms5.revize.com/revize/eustisfl/Develop Services/AC Changeout Per… · of HVAC Evaporators and condensing unit, all accessible (a minimum of

BUILDING PERMIT APPLICATION - PAGE 2

Building Contractor:______________________________ M/H Set-up Contractor:_______________________________ State/Cert/Reg #__________________________________ State/Cert/Reg #_______________________________________ Address_________________________________________ Address _____________________________________________ City ___________________________________________ City ________________________________________________ State _______________________ Zip_________________ State ___________________________Zip _________________ Phone ______________________Fax _________________ Phone __________________________Fax_________________ Cell ________________Email:_______________________ Cell ________________Email:__________________________

Signature _______________________________________ Signature ___________________________________________

Plumb Contractor:______________________________ HVAC Contractor: _________________________________(*)State/Cert/Reg #__________________________________ State/Cert/Reg #_______________________________________ Address_________________________________________ Address _____________________________________________ City ___________________________________________ City ________________________________________________ State _______________________ Zip_________________ State ___________________________Zip _________________ Phone ______________________Fax _________________ Phone __________________________Fax_________________ Cell ________________Email:_______________________ Cell ________________Email:__________________________

Signature _______________________________________ Signature ___________________________________________

Elec. Contractor:________________________________ LP Gas Contractor:___________________________________ State/Cert/Reg #__________________________________ State/Cert/Reg #_______________________________________ Address_________________________________________ Address _____________________________________________ City ___________________________________________ City ________________________________________________ State _______________________ Zip_________________ State ___________________________Zip _________________ Phone ______________________Fax _________________ Phone __________________________Fax_________________ Cell ________________Email:_______________________ Cell ________________Email:__________________________

Signature _______________________________________ Signature ___________________________________________

Specialty Contractor:_____________________________ Engineer/Architect:___________________________________ State/Cert/Reg #__________________________________ State/Cert/Reg #_______________________________________ Address_________________________________________ City ____________________________________________ State _______________________ Zip_________________ Phone ______________________Fax _________________ Cell ________________Email:_______________________

Signature _______________________________________

CONTRACTOR—PLEASE COMPLETE INFORMATION AND SIGN IN APPROPRIATE BLOCK BELOW. BY SIGNING BELOW, I HEREBY SWEAR THAT I AM IN COMPLIANCE WITH FLORIDA’S WORKER’S COMPENSATION LAW AND THAT I HAVE SECURED COVERAGE OR HAVE A VALID CERTIFICATE OF EXEMPTION.

(*) NOTE TO HVAC CONTRACTOR: FLORIDA BUILDING CODE – ENERGY EFFICIENCY, REQUIRES THAT THE CONTRACTOR PROVIDE MANUAL J & MANUAL N ON ALL NEW CONSTRUCTION AND REPLACEMENT HVAC SYSTEMS ; CONTRACTOR MUST ALSO PROVIDE CERTIFICATION THAT ALL DUCTWORK HAS BEEN INSPECTED AND ALL NECESSARY REPAIRS/TAPING HAVE BEEN COMPLETED.

Approved by ______________________________________ Date: _______________________________Permit Application Form – May 2018

Page 4: HVAC MATCHING EQUIPMENT CERTIFICATIONcms5.revize.com/revize/eustisfl/Develop Services/AC Changeout Per… · of HVAC Evaporators and condensing unit, all accessible (a minimum of

Permit Number: __________________

A. OWNER OR LESSEEEMAIL ADDRESS FAX NO.

NAME TELEPHONE NO.

ADDRESS CITY STATE ZIP CODE

B. BONDING/MORTGAGE NAMESFee Simple Titleholder, Bonding Company, Mortgage Lender and Design Professional information is required when the aggregate value (total cost of all improvements and not just work authorized by the individual permit) is $2,500 or more (except HVAC repair/replacement > $7,500). NAME ADDRESS, CITY, STATE & ZIP TELEPHONE NO.

FEE SIMPLE TITLEHOLDERS (IF OTHER THAN OWNER) □ SAME AS OWNER

BONDING COMPANY □ NOT APPLICABLE

MORTGAGE LENDERS □ NOT APPLICABLE

DESIGN PROFESSIONAL LICENSE #

PRIMARY CONTACT EMAIL ADDRESS PRIMARY CONTACT CELL PHONE NO.

III. OWNER & LENDER INFO

BUILDING PERMIT APPLICATION - PAGE 3

Important!Yes No (Check one) I am filling and /or excavating the property. If yes, provide the Finish Floor Elevation (FFE) , lot corner elevations and drainage plan for the site. Depending on the type of development, not all information will be required. Note: Failure to respond correctly will make you personally liable for future damages.

Permit Application Form - May 2018

user
Typewritten Text
Building Code in Effect: 2017 (Sixth Edition) Florida Building Code