Fillable Form 20: Building Construction Services (Charlotte County BCC)

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Form 20: Building Construction Services (Charlotte County BCC)

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BROWSE CHARLOTTE COUNTY BCC (FL) FORMS

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Building Construction Services
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingSvcs@CharlotteCountyFL.gov
www.CharlotteCountyFL.gov
"To exceed expectations in the delivery of public services"
Application Date
Permit Number
For Office Use Only
20
CSR Initials
HVAC REPLACEMENT PERMIT APPLICATION FOR COMMERCIAL BUILDINGS
IN COMPLIANCE WITH FBC Sixth EDITION (2017)
A recorded Notice of Commencement is required in the Permitting Office prior to the first inspection.
12/2017 jg
1 of 4
Range
Unit #
Tax Folio # Lot Block
Section
Subdivision
This building will be used as
Map Page
Flood Zone
City
State
Owner Information
Phone No.
Fax No.
Email
Contractor Information
Name
Construction Cost (excluding lot but including labor)
Township
Wind Zone Exposure
Zoning Class
Contractors State Certification or Registration No.
Contractors Certificate of
Competancy Number
Job Site Details
Number
Name
Type:(St., Dr., Pkwy., Blvd., etc.)
Address
Description of work to be done:
Address:
Number
Name
City
State
Phone No.
Fax No.
Email
Name
Address
Number
Name
Type:(St., Dr., Pkwy., Blvd., etc.)
Building Valuation
Year Built
Notice of Commencement is required for all jobs
$2,500 ($7500 for HVAC) or more.
Type:(St., Dr., Pkwy., Blvd., etc.)
Building Construction Services
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingSvcs@CharlotteCountyFL.gov
www.CharlotteCountyFL.gov
"To exceed expectations in the delivery of public services"
Application Date
Permit Number
For Office Use Only
20
CSR Initials
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in
this jurisdiction.
A recorded Notice of Commencement is required in the Permitting Office prior to the first inspection.
012/2017 jg
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OWNERS/AGENT SIGNATURE
State of Florida, County of
Signature of Notary
Notaries Printed Name
Commission Number
The foregoing instrument was acknowledged before me this
day of 20 by
who is personally known to me or who
has produced as identification and
who did/did not take an oath.
CONTRACTORS SIGNATURE
Signature of Notary
Notaries Printed Name
Commission Number
The foregoing instrument was acknowledged before me this
day of 20 by
who is personally known to me or who
has produced as identification and
who did/did not take an oath.
The undersigned applicant for this permit does hereby certify that he/she has or will prior to the performance of any work in connection
with the authorization granted under this permit comply with the provisions of the Florida Worker's Compensation Act of Employers
Liability Insurance, the Social Security Act, the Florida Child Labor Laws and all other applicable safety and labor laws of the state.
Violation will invoke severe penalties..
Owners Affidavit: I hereby certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR 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 YOU LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTICE: In addition to the requirement 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 governmental entities such as water
management districts, state, or federal agencies.
Name of Fee Simple Titleholder (if not owner)
Street City State Zip Phone No
Bonding Company Name
Street
State
Zip
Architect/Engineer Name
Mortgage Lender
Street
State Zip
Street State Zip
State of Florida, County of
HVAC REPLACEMENT PERMIT APPLICATION FOR COMMERCIAL BUILDINGS
IN COMPLIANCE WITH FBC Sixth EDITION (2017)
Building Construction Services
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingSvcs@CharlotteCountyFL.gov
www.CharlotteCountyFL.gov
"To exceed expectations in the delivery of public services"
Application Date
Permit Number
For Office Use Only
20
CSR Initials
Please note, correct licensure is required to perform each task.
Two copies of the completed permit application form. All commercial alterations, remodels or additions with duct work require plans review.
FBC, Energy Conservation.
Residential buildings not more than three stories above grade shall meet the Residential Provisions of Chapters 1 thru 5.
Residential Multifamily and Commercial buildings shall meet the Commercial Provisions of Chapters 1 thru 5.
Existing mechanical systems undergoing alterations shall comply with Section 301.11 of the Florida Building Code, Mechanical.
Existing buildings shall meet the criteria in Table 101.4.1 FBC, Energy Conservation, as appropriate to the condition described.
Plans must be supplied and additional criteria may apply if property is located in the Charlotte Harbor CRA. If so, the project must meet
the CRA Design and Community Standards. For more information call Zoning on (941) 743-1964.
ARI Rating
A recorded Notice of Commencement is required in the Permitting Office prior to the first inspection.
12/2017 jg
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WHEN REPLACING BOTH THE AIR HANDLER & CONDENSER AND CHANGING BTUH CAPACITIES
ARL or other recognized testing laboratory
Letter from Mechanical Engineer, Florida Registration number:
Manufacturer's letter
Provide with permit application heating/cooling load calculations per ACCA, manual "J" for residential and small commercial, manual
"N" for large commercial.
Provide certification of Mandatory Duct Inspection before or at final inspection
New unit, either outdoors or indoors, shall be designed/sized to be operated with existing remaining unit to produce the same SEER/EER/
COP rating as the existing original system. This match shall be verified by any one of the means listed below. Original of verification shall be
included in the permit application.
The replacement unit shall be certified for capacity and efficiency by one of the following: (check one and submit with permit application )
WHEN REPLACING ONLY ONE COMPONENT EITHER THE AIR HANDLER OR CONDENSER (provide documentation)
If new unit is rooftop mounted or suspended from existing structure and the weight (lbs) of the new unit exceeds weight of the existing
unit by more than 5%, the supporting structural components shall be evaluated by a Florida Registered Professional Engineer for
compliance with the requirements of the Florida Building Code-Building. PROVIDE WEIGHT in lbs: (EXIST)________ NEW:_________
Provide engineer's original signed sealed evaluation report and/or required structural upgrade details with the application (if not size for
size).
If a new roof curb or curb adapter is required, provide manufacturer's detail showing new curb or curb adapter installed to meet new
dead, live and wind loads. In lieu of manufacturer's details, Florida registered engineer's original signed sealed details can be provided.
HVAC REPLACEMENT PERMIT APPLICATION FOR COMMERCIAL BUILDINGS
IN COMPLIANCE WITH FBC Sixth EDITION (2017)
New RTU will fit existing roof curb. Provide manufacturer detail/s showing attachment of new RTU to existing curb to meet applicable
dead, live and wind loads. In lieu of manufacturer's details, Florida registered engineer's original signed sealed details can be provided.
NEW:
EXIST:
SPECIFIY MOUNTING METHOD FOR EACH UNIT (ROOFTOP, FLOOR, SUSPENDED, OTHER)
PROVIDE NOMINAL TONNAGE OF EXISTING & NEW UNITS
NEW:
EXIST:
PROVIDE ACTUAL TOTAL BTU/H CAPACITY OF EXISTING UNIT & NEW UNIT
PROVIDE ELECTRICAL FOR EACH NEW COMPONENT: VOLTAGE, AMPERAGE BREAKER SIZE?
PROVIDE ENERGY EFFICIENCY RATING PER ENERGY CODE TABLE C403.2.3(1)(2) OR (3) (SEER, EER, HSPF, COP)
NEW:
EXIST:
NEW:
EXIST:
NEW:
EXIST:
Building Construction Services
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingSvcs@CharlotteCountyFL.gov
www.CharlotteCountyFL.gov
"To exceed expectations in the delivery of public services"
Application Date
Permit Number
For Office Use Only
20
CSR Initials
DUCTWORK MODIFICATION REQUIRED?
A recorded Notice of Commencement is required in the Permitting Office prior to the first inspection.
12/2017 jg
4 of 4
HVAC REPLACEMENT PERMIT APPLICATION FOR COMMERCIAL BUILDINGS
IN COMPLIANCE WITH FBC Sixth EDITION (2017)
NEW SYS. HEAT PUMP? (AIR SOURCE, WATER SOURCE,GEOTHERMAL, OTHER)
EXISTING SYSTEM-ELECTRICALLY OPERATED SPLIT SYSTEM?
NEW SYSTEM ELECTRICALLY OPERATED SPLIT SYSTEM?
EXISTING SYSTEM ELECTRICALLY OPERATED PACKAGED UNIT?
NEW SYSTEM ELECTRICALLY OPERATED PACKAGED UNIT?
EXISTING S. HEAT PUMP? (AIR SOURCE, WATER SOURCE,GEOTHERMAL, OTHER)
EXISTING SYSTEM OTHER THAN PACKAGE OR SPLIT? EXPLAIN
REPLACING BOTH AIR HANDLER AND CONDENSING UNITS?
REPLACING AIR HANDLER ONLY?
REPLACING CONDENSING UNIT ONLY?
CHARACTERISTICS OF UNIT/S
WHERE QUESTION/S IS/ARE NOT APPLICABLE, FILL IN BLANK (S) WITH "N/A"
COMMENTS
MANUF. NAME & MODEL/SERIAL NUMBER OF ALL NEW & EXISTING
EQUIPMENT.
EXIST:
NEW:
explanation as to why the difference.
BTU/H CAPACITY: If tonnage of new unit is less than or greater than tonnage of the existing system, provide detailed
Title
Signature
Authorized Representative Name and Title:______________________________________
Date
*IF MODIFICATIONS TO DUCTWORK ARE REQUIRED, PROVIDE COMPLETE DUCT LAYOUT
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Form 20: Building Construction Services (Charlotte County BCC)

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Completed 21 January 2021

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