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HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: V 7 -/ 7. Permit Number: vulming rermit ApplICailon Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 452-2553 Fax: (772) 452-11578 Commercial Residential PEKMI I APPLICA I ION I-OR: To Select from dropiaox, click arrow at the end of line PROPOSED IMPKOVEMEN I LUCA I ION: Address: Legal Description;: Property Tax ID #: ��07 %` 50.2 "�a o2T - Lot No. Site Plan Name: Brock No. Project Name: Setbacks Front Back: Right Side: Left Side: UE I Al LEU UESC:KIP 11UN Ul- WURK: L TION INFORMATION: [�d�d—itti=bnalwofk, o e er rale un ert is permit-c ec a tuppZ r:VAC �GasTank ❑Gas Piping �Nindovjs/Doors _Shutters 1-1 Electric Q Plumbing Sprinklers Generator IL Roof Roof pitch Total Sq. Ft of Construction: Sq. �Ft. I{of First Floor: 0Septic Cost of Construction:$ G,of�O Utilities:L=l Sewer Building Height: OWNERf LESSEE: CONTRACTOR: Name ✓ �� %Y%[' Name: ,YAM kv\c n ,; Address: /pD9 �d� fa �� Company: Cu n-ro rvt City: State:/ Address: 1&15 S E dG•e Lee Q / Zip Code: Fax: City: (50- PLT St , L uc(e­ State. rte- r Phone No. 5'/7 ' abi 6 - /6 O Zip Code: IT+g52- Fax: 11 rt,?- J 35-I 9 E-Mail: Phone No. `I'll 33:5`3231 Fill in fee simple Title Holder on next page ( if different E-Mail: C u a t C, i r �p cc c rr�- from the Owner listed above) State or County License: if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUFPLF-MENIAI_CONS IRUCHUN LIEN LAW INLUtiMAIION.- DESIGN€R/€NGIN€ER: Not Applicable i MORTGAGE COMPANY, _ Not Applicable . Name: Name: address: Address: City: State: , City: State: Zip: Phone: Zip: Phone: i FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDiNG COMPANY: Not Applicable Name: Dame: Address: City ' Address: City: Zip: Phone: Tp: Phone: i certify that no .aorto or installation has commenced prior to the issuance of a perm St Lucie Countv makesno representation that is granting a permiiratl authorize the permit holder to build the subject structure %.,hick is in conflict wraith any applicable home Owners Association rules, bylal-os or and covenants that may restrict or prohibit such structure_ Please consult.•nth your Home Owners Association and revieUi your deed for any restrictions whiai may apply_ In consideration of the granting of this requested perm -t, I do hereby agree that t .wll, in all respects, perform the work in accordance i!.ith the approved plans, the Florida Building Codes and St- Lucie County Amendments. The foliovLing building permit applications are exen=ptfrom undergoing a full concurrency review: room additions, accessory structures, sMmming pools, fences, :ua ls, sign : 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 property- A Notice of Commencement must be recorded and posted on the jobsite before the first inspection- If you intend to obtain financing, consult with lender or an attomey before commencing work or recording your Notice of Commencement. s Signature of owner/-essee'Contracor as Kgentfor a.,.,ner Signature of ContractorlLicense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF - COUNTY OF The forgoing instrument ,las acknowledged before rine � The forgoing instrument was ackno. Hedged before me this _[_ day of Sf4t Zfl Lf by this f_day of l ,=Q19 by i I - - (Name of person ackno.:ledging j (Name of person. aclmo.s ledging i (Signature of Notary Public-StatEx -of F—crida j (Signature of Notary Public -State o; =loaf; Personally Kno..m OR Produced Identification Personally Knovn OR Produced Identification Type of Identiiicanon Produced Type of Identification Produced ��rr - CIIRi5riMB mission No_ Commission No- '_ _ _ sq _ * GORM _ RetsedG-1-;1Si2G14E! `oma MZS-Ap;04,21t l REVIRAJS FRONT ZONING ` SUPERVISOR i PLANS ` VEGETATION SEA TURTLE MANGROVE COUNTER REVIEWREVIEW1 REViRAJ REMEW REViE N' REVIEW DATE i t E COMPLETE , INITIALS ,1 Custom Air Systems Inc. r i 1615 SE Village Green Drive • Port St. Lucie, FL 34952 (772) 335-3232 Fax ( 772),335-1968 C Proposal and Agreement rfkc-C-1110 G O� Phone ,29` 1ObU Customer Name Address 379 City, State, Zip We will furnish, install and service the Make j el 1` SEER EER AS�F,, � l� In 'all n all1 dude:N U 0 ❑ New Amp disconnect ❑ New Amp electric service ❑ New low voltage wiring ❑ New weather resistant equipment stand New reinforced equipment pad New vibration isolation pads E. New properly sized refrigerant lines ❑ New clean, dry ACR copper tubing ❑ Insulate refrigerant suction line(s) ❑ Install refrigerant drier(s) C Evacuate refrigerant system Charge to manufactu is specs eet all federal, s to & local laws 0 below Terms: Acceptance ustomer) By 0 �oo©r�Or000c— Job Address 0 Dateso ��1'�0 0 Work Phone(s) equipment listed below at the price, terms and conditions outlined on this proposal. Equipment Specifications ❑ Install energy savisetback tnermostat r•-••• ❑ New copper wire fr to LiInstall aux. condensai ❑ Make air tight plenum sition ❑ New high effici ❑ new supply diffuser(s ❑ tfication system ❑ New duct run from to ❑ New return air filter grill ❑ Noise reducing flexible duct connector ❑ Meet all code requirements ❑ Balance for uniform supply 'air distribution ❑ Complete system start up ❑ Provide for external combustion air ❑ year parts warranty ❑ New gas piping from to ❑ year labor warranty ❑ New vent pipe and cap ❑ year compressor warranty ❑ Clean work area to customer's sat action ❑ year service agreement ❑ Condensation overflow sa switch Hurricane Fasteners outdoor unit� Total Investment $ Taxes $ r roy Total Amount $ e�, `f Down Paymea t Ante , t $ Balance Due Date fto