HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��"' I Permit Number:
ouim ing rermit Appucavon
Manning and Development Services
Building and Code Reguloiion Division
2300 Virginio Avenue, Fort Pierce Ft 31982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PEKMI I APPLICA I IUN FUR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPRUVEMEN I LUCAI ION: !
Address: / 7 -/ D �, "00e q 6 r O-6 /< %J r \ ,_-
Legal Description:
Property Tax ID Pr: �3 ooc: ," J 0 ` S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
UE I AILED UESCKIP I ION Ul- WORK: �
CONSTRUCTION INFORMATION:
Additional -%W rkto oe oerformed-- under this permit - check all (t --a ppT,r -
� iVAC Gas T ank -]Gas Piping I =1 Shutters Windows/Doors
l
Electric Plumbing Sprinklers Generator 1Roof Roof pitch
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction: $ � Utilities: D Sewer Septic Building Height:
f OWNER/LESSEE: CONTRACTOR:
Name _lZiO ei Name: C U 1`211 tA 61 O'l C n
Address: /''CXS� /L.Company: CLt,TC, nt A , r SLR S `� PEII; <<
City: State: >= Address: l l 5 Lit l ceci -� �r ee i1
City: y: i�v2r Sr. Lucie_.
Zip Code: State: �t-
PhoneNo.77CA Y �Da�� ;Zip Code: ='f452 Fax:
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E-Mail: Phone No. "� a 33S- 3 3-
Fill in fee simple Title Holder on next page ( if different E-Mail: u S t cl I r S ti CL 0 o'L
from the Owner listed above) State or County License: O
If value of construction is $2500 or more, a RECORDED Notice of commencement is required. ^-
SUPPLEMEN I AL GUNS i RUC l ION '-LIEN LAW INFORMA 1 ION:
DESIGNER%ENGINEER* _ Not Applicable
! MORTGAGE COMPANY- Not Applicable
Name:
Name:
Address:
I Address:
City: State:
± City: State:
Zip: Phone:
i Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address }
City:
City
Zip: Phone:
Zip: Phone:
I certify that no ;~cork or installation has commenced prior to the issuance of a perrlit
St_ Lucie County makes no representation that is granting a permit vLill authorize the permit holder to build the subject structure
v:hich is in conflict tvith any applicable home Owners Association rules, bylaw, s orano covenants that may restrict or prohibit such
structure_ Please consult %mith your Home Owners Association and revie:v your deed for any restrictions which may apply.
in consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance ;%ith the approved plans, the Florida Building Codes and St_ Lucie County Amendments.
The follo.kiing building permit applications are ekenapt from undergoing a lull concurrency review: room additions,
accessory structures, sw4mming pools, fences, :ua'ls, signs — screen rooms and accessory uses to another nor. -residential use
WARN ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your properly- A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. if you intend to obtain financing, consult:arith lender or an attomey before
commencing work or recerdingyour Notice of Commencement.
s
Signature of 0v-,ner/Lessee;ControuLor as Hgentfor O,,vner
Signature of ContractorjLicense Holder '
t
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
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The forgoing instrument -fas acknowledged before me i
The forgoing instn ienY :vas acknauledged before me
this day of � za /10 1, (
i
1
t111S day of (J <Q A by
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(Name of person ackrovdedging j 1
(Name of person ackno:=:(edging )
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(Signature of Notary Public -State of F erida ' (
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(Signature of Notary Public -State of Floriq,, I
Personally Known OR Produced Identification
Personally Known 03 Produced identification
Type of Identification Produced }
Type of Identification Produced
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COMPLE T E
INITIALS ----- — t
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Custom Air Systems Inc. l
1615 SE Village Green Drive • Port St. Lucie, FL 34952
J (772) 335-3232 • Fax( 772) 335-1968
Proposal and Agreement
lJ •, � � � � �
J Customer Name � 66 &/- `X � -- Phone Date-
5 W
Job Address ..`
Address —T
City, State, Zip iT!� C'� ! — Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal. D
Equipment Specifications
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Make r Model Number(s) PAPIl
SEER EER AFUE Btuh Cooling Btuh Heating A' FM
T I
Installation shall include:
r G s A-
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O X in boxes = Yes
❑ New Amp disconnect Remove existing equipment from premises ❑ New condensate drain system
❑ New Amp electric service ❑ Install energy saving setback thermostat ❑ New condensate pump
❑ New low voltage wiring ❑ New copper wire from to ❑ Install aux. condensate drain pan
❑= New weather resistant equipment stand ❑ Make air tight plenum transition El New high efficiency air filter
� N'ew reinforced equipment pad ❑ new supply diffuser(s) ❑ New humidification system
❑ New vibration isolation pads ❑ New duct run from to ❑ New return air filter grill
❑ New properly sized refrigerant lines ❑ Noise reducing flexible duct connector ❑ Meet all code requirements
❑ New clean, dry ACR copper tubing ❑ Balance for uniform supply air distribution ❑ CoTRIete system start up
O ❑ Insulate refrigerant suction line(s) ❑ Provide for external combustion air ❑ __5 year parts warranty
❑ Install refrigerant drier(s) ❑New gas piping from to ❑ year labor warranty
❑ acuate refrigerant system El New vent pipe and cap ❑ year compressor warranty
tion '
rk area to customers satisfaction ❑ Y -�
� Cha a to manufacturer's specs ear rvice reed r
eet all federal, state &local 1 — ❑ Co densa�tlQn overflow safety switch ❑+�
Hurricane Fasteners for outdoor unit
El Option (below) ElTotal Investment $
Taxes $
Total Amount $ t
Down Paymeat $
Balance Due $
Terms: .-
Acceptance ( stomer) Approval
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By
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