Fillable Broward County Uniform Data Form for Residential and (Broward County)

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Broward County Uniform Data Form for Residential and (Broward County)

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The Broward County Uniform Data Form for Residential and (Broward County) form is 1 page long and contains:

  • 1 signature
  • 8 check-boxes
  • 37 other fields

Country of origin: US
File type: PDF

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BROWSE BROWARD COUNTY (FLORIDA) FORMS

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Board of Rules & Appeals Policy 19-02 Effective October 1, 2019
Job Name:
Address:
Unit # City
c/u ahu/pkg c/u ahu/pkg
c/u ahu/pkg c/u ahu/pkg
c/u ahu/pkg c/u ahu/pkg
Will a new stand, curb or curb adapter be installed?
Yes No
Yes No
Yes No
Yes No
Qualifier's signature
Process or Permit #
Date
Disclaimer:
1. This form does not relieve the applicant from compliance with all applicable sections of the Florida Building Codes.
2. Additional local regulations might be applicable, i.e. zoning, flood and fire prevention, etc.
Is the duct s/d connected to an Fire Alarm Panel?
(1) Provide equipment sizing calculations if existing unit data is not available (ACCA Manual N, J, etc)
(2) Provide AHRI Certificate
Approved by
FL. State or Co. Licence #
FOR BUILDING DEPARTMENT USE ONLY
Jurisdiction
Will the A/C location will be the same ?
Company name
Size of Disconnect
Minimum Circuit Amps
Maximum Overcurrent
Protection
Model #
KW Strip Heat
Condensing Unit Model #
AHU Model #
Package/Heat Pump Model #
Manufacturer
SEER (2)/EER (2)
New Unit
Broward County Uniform Data Form for
Residential and Light Commercial Air Conditioning Replacements
All others, including cooling towers, chillers, refrigeration units, etc. must provide plans.
Each system requires a form.
Data
Existing Unit (1)
FL ZIP Code
Fill in applicable information
G:\SHARED\2019 BR&A\AC Replacement Form
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signature
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Print
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Broward County Uniform Data Form for Residential and (Broward County)

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Completed 8 February 2021

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