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Buiding Permit
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Jr'-// / �GOtiNTY �`` F L O R 1 O p Permit Number: auilialing vermes iA lif'ation Planting and CevelaNrnent Ser:, -ices Building and Code Regulation L>rvision 2300 Vrginio Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-=578 PEKMII APPLICAIIUN FUR: Commercial v Residential To Select from dropbox, click arrow at the end of line 1 YHUI'USI=U IMYKUVEMENI LUCAIIUN: Address:- S d r� l,Jl� s �r �' 7�►^u q, a�.� �f - - ----- ._ Legal Description: Property Tax ID P: Site Plan Name: Lot No. Project Name: Block No, Setbacks Front Back: Right Side: g Left Side: UEIAILEU UESCKII'IIUN Ut- VVURK: - r_ r L/hc_ 2 CAAhSC_ 0vT- l_t1 Iq St�c_ Q CONSTRUCTION INFORMATION: -- Addff oa wor to be oe armed -under this pe�mif�deck t app Y -- ---- - -- 4 H VAC Gas Tank _ -- ❑Gas PipingShutters Windows/Doors rs Electric Plumbing Sprinklers � Generator Roof Rcof pitch Tota Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: LiSewer Dseptic Building Height: OWNERAESSEE: __-- ; ------ _- ( CONTRACTOR: --- -- Name T.- I,,+ lam,„ -T'..,., -F G- 1 Address:_QoO Cnm mr n WQn i f3 Q City: 7Q� c�1•, oo . State: FL Zip Code: 3 a3 q Q. Fax: Phone No. E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_LUrLTI r I-SAar t'1 Co Com pang: 6U-27'atit A , r Ce: VVIS Address: ( [ 5 r i t et cr r ee n City: _P10 2T 9t. L c t State: Zip Code: I+g51- Fax e Phone No. Tl 3 3 5- 3 2 3 2 E -Mail CL{ ; tc_Ir Sy Qni cG�oti State or County License: C C? .51 fs ( rJ If value of construction is $2soo or more, a RECORDED Notice of Commencement is required. am SUPPLEMEN I ALCONS I RUC I ION LIEN LAW INF-URMAIIUN. DESIGNER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: i Name: — Not Applicable Address: Name: City: i address: State: I City: Zip: Phone: Late: 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 work or installation stns commenced prior to the issUance of a perm it- St- i ucie Countv makes no representation that is granting a permit t gill authorize the permit holder to build the subject structure which is in conflict with any app6cab'e Nome Owners Association rules, bylai.rs orand covenants that may restrict or structure- Please consult :,lith Horne O*tivners your prohibit such Association and revie,•J`your deed For any restrictions which may apply. In consideration Of the granting of this requested permit, i do hereby agree that I :vill, in all respects, perform the pork in accordance 'r-ith the approved plans, the Florida Building Codes and St- Lucie County Amendments_ The following building pe,-mit applications are exen=ptfrom undergoing a full concurrency review_ room additions, accessory structures, stArimming pools, fences, walls, signs, screen rooms and accessonr uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Comm - improvements to your property. A Notice of Commencement must be recorded and your before the first inspection. if d o g twice for you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice Commencement. of .. �. .i -.i �:. `..�L••� ;moi _ (� Signature of Cortrador/License Holder s Srgnarure of Or+-ier/LesseejCantracior as Agent for Owner STATE OF FLORIDA i STATE OF FLORIDA COUNTY OF tS �. .' ' COUNTY OF { The forgoing instrument .vas acknowledged before me i The forgoing instrument was acknov.ledged before this , 10 day of S (1 t <fl t a b me this l (o day of $, 20 1 Q. by YA ,Name or person acknowledging) t ;Name of person acknertledging) (signature of Notary Public-Stateof rloriaa (Signature or Notary Pubhc- State of Fiotlda } Personal =' I 11+ Known OR Produced Identification Type of Identification Produced ' Personally Known OR Produced Identification Type of identification Produced 1 ✓'! i i 4 �,�t Commission No- C`f G"r �' ✓ cHMTiNEB �x c• rq`SS�, !pw 'Kr`'ux *, mission No. ��t Lr (? c>! Ll � � � : MY COMM1SWON # Ci c'1 q, -•�_ . • . _ � I 3G05256 * c SMES:April 2021 m' .4, i 0j'r.0 aondea rntu fkdget ftvy Revised 07115/2014 sumes # 1, * MYCOWAMON#cG T, < OICAM1a,2021 REVIRAI S i FRONT ZONING SUPERVISOR i PLANS VEGETATION COUNTER REVIEW REVIEW REVIEW - SEA TURTLE 1 MANGROVE i DATE r REVIEW REVIEW ffEVlcVV COMPLETE _- INITIALS am Custom Air Systems Inc. 1615 SE Village Green Drive • Port St. Lucie, FL 34952 — (772) 335-3232 • Fax/(772)335-1968 ��' `, ^`Ce///`C ova' 3C)a S Pr4ZI and Agreement Customer Name -In � 2-� 54a Vie r Phone Address W's- City, 0 City, State, Zip Fo,4,'e r Le, Job Address Work Phone(s) P-jck-�e �2 2 0 Date We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal. Equipment SpecificationsjMake �L;--" Model Number(s) 43© P rl pst) i 7 SEER�LEER AFUE Btuh Cooling `> O j� Btuh Heating CFM Installation shall include: ❑ New Amp disconnect ❑ New Amp electric service ❑ New low voltage wiring New weather resistant equipment stand ❑ New reinforced equipment pad C New vibration isolation pads New properly sized refrigerant lines ❑ New clean, dry ACR copper tubing ❑ Insulate refrigerant suction line(s) ❑ Install refrigerant drier(s) ❑ Evacuate refrigerant system E Charge to manufacturer's specs ❑ Meet all federal, state & local laws ❑ Option (below) Terms ❑ Remove existing equipment from premises El Install energy saving setback thermostat ❑ New copper wire from to ❑ Make air tight plenum transition ❑ new supply diffuser(s) ❑ New duct run from to ❑ Noise reducing flexible duct connector ❑ Balance for uniform supply air distribution ❑ Provide for external combustion air ❑ New gas piping from to T ❑ New vent pipe and cap ❑ Clean work area to customer's satisfaction ❑ Condensation overflow safety switch ❑ Hurricane Fasteners for outdoor unit X in boxes = Yes ElNew condensate drain system ❑ New condensate pump ❑ Install aux. condensate drain pan ❑ New high efficiency air filter ❑ New humidification system ❑ New return air filter grill ❑ Meet all code requirements ❑ Com fete system start up ❑ year parts warranty ❑ year labor warranty ❑ year compressor warranty ❑ year service agreement Total Investment $ 3i1` s �--Q Taxes $ U Total Amount $ Down Paymeat $ Balance Due $ Acce ustom Approval ( y ByDate By Date 6 ®®®®®®000000000000m000000000�