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HomeMy WebLinkAboutBUILDING PERMITALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � -17 -/ Permit Number: • ouliaing reE (Till HppIICa-Ella 1 Planning and Development Serrices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 402-1553 Fax: (772) 462-1578 Commercial Residential PEKMI I APPLICA I ION FUR: To Select from dropbox, click arrow at the end of line PROPOSED IMPKUVEMENI LOC:AIION: Address: Legal Description: Property Tax ID I?: d�110- 33 -DDO - y Lot No. —___ Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DE I AILED UESCKIP I ION OF WORK: L lltc for L/kc 3Ten IVSe r e'/,AnS- ou'T— ��1.✓ CONSTRUCTION INFORMATION: ��Ftt��ra��r ct—to"6e 6erformed under LLffHVAC ,j Gas Tank 11 Electric ED Plumbing Total Sq. Ft of Construction: Cost of Construction: $ z� _b OWNER/LESSEE: Block No. this perms"t = ch6c-Tt aTl- app y: 7Gas Piping Shutters Windows/Doors Sprinklers [I Generator Ll Roof Roof pitch Sq. Ft. of First Floor: Utilities: [—] Sewer a Septic Name-rumCtiYt �Q��Pr q/nP_146d4; L a%silnp�i Address: `/Q00 AA,6"-n 0ti City: �c P/�G� State: FL Zip Code: 319A2- Fax: Phone No. 50 q 79 6 0 e?3 E-Mail: Fill in fee simple Title Holder on next page( if different from the Owner listed above) CONTRACTOR: Building Height: _ Name: CU1LTIS 'YAtttmC11 Corr, pang: C u 3-To rK A % r- ls cl S t ems ru Address: et C �{reer1 City: Co R-r St . L uCi State: r-� Zip Code: 3 +q 52 - Fax: 7'T? J -3 5- 19 6 W Phone No. 'X `T a, 3 3 S- 3 2- 3 2- E-Mall: ail `=tC'ir Sys -P CkC, CGvn State or County License: C` C C 5( 8 1 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required, SUPPLEMEN I AL CONS I RUC I [ON LIEN LAW INFURMAIION: DESIGNER/ENGINEER: Not Applicable I MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: ! Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable — BONDING COMPANY: Not Applicable I Name: Name: j Address: Address: i City: City: Zip: Phone: zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. makes no representation that is granting a penit \will authorize the permit holder to build the subject structure St. Lucie Countym which is in conflict %,vith any applicable home Owners Association rules, b��laxvs or ana covenants that may restrict or prohibit such structure- Please consult :with your Hone Owners Association and revie:y your deed for any restrictions -which may apply. in consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The follo.L+ing building permit a3pGcations are exen-ptfrom undergoing a full concurrency review: room additions, accessonr structures, swimming pools, fences, signs, screen rooms and accessoR+ uses to another non-residentiai 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 attorney before commencing work or recording your Notice of Commencement. i Signature of Owneri_essee,!Contractor as Agent for O:Vner Signature of Contracfor!License Holder STATE OF FLORIDA j STATE OF FLORIDA "' COUNTY OF S . _ COUNTY OF I The forgoing instrument :vas acknowledged before me i The forgoing instrument was acknowledged before n:e this ^, day of Sze 20b�- I this I7 day of is n t ZO i 9 by i i (Name of person acknowledging) (Name of person acknovLledging ) (Signature of Notary Public- State of Rcr;ria )! (Signature of Notary Public- State Of Norida j Personally Known OR Produced Identification Personally Krimvn OR Produced Identification Type of Identification Produced Type of Identification Produced ✓`I Y° CHRISTiNEBENWftmission No. �'i't t J< ��;:?_ . • .: • _ r Commission No_ (rT G7 �` �;� Ltd . ?q E t I W° ISSION # GG 052546 * * saMYCOMMEEXPH a� p 2an S .. &kgetN yServrrs r �•. <i� £HRiS4NEBT7iGLM MY C(AWSSiON 1 GG 0525Q * Revised0;/15i2014 ��EXPIRES:Apri!a,2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION l SEA TURTLE MANGROVE COUNTER REVIEW T REVIEW I REVIEW REVIEW REVIEW REVIEW DATE COMPLE T E INITIALS - --- —� a_ iSH 09"s J21 u-vkn vJ eY Cj — Custom Air Systems Inc. 1615 SE Village Green Drive - Port St. Lucie, FL 34952 (772) 335-3232 - Fax ( 772) 335-1968 `%� - MeL P 7oposal and Agreement o 4 Customer Name / r m A Phone S l3 % o Date / ( � Address Job Address 3n PA vro 'l 5 D r �1 3y 7 r,L City, State, Zip Work Phone(s) We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal. G,�DA^an nHi 3 434 Equipment Specifications oroirS-.-.1306 0 Make SEER EER— Installa ' n shall inc e: _ Model Number(s) AFUE Btuh L �<<. �A >\ J2cr ing Btuh /Heating p CFM_ ❑ New Amp disconnect ❑ Remove existing equipment from premises ❑ New Amp electric service ❑ Install energy saving setback thermostat ❑ New low voltage wiring ❑ New copper wire from to ❑ New weather resistant equipment stand ❑ Make air tight plenum transition f ed ' ment ad El new supply diffuser(s) rf X in boxes = Yes ❑ New condensate drain system El New condensate pump ❑ Install aux. condensate drain pan El New high efficiency air filter ❑ New humidification system New rem orc equtp p El New vibration isolation pads El New duct run from to ❑ New return air filter grill ❑ New properly sized refrigerant lines ❑ Noise reducing flexible duct connector ❑ Meet all code requirements D ❑ New clean, dry ACR copper tubing ❑ Balance for uniform supply air distribution ❑ Complete system start up ❑ Insulate refrigerant suction line(s) ❑ Provide for external combustion air ❑ year parts warranty ❑ Install refrigerant drier(s) ❑ New gas piping from to ❑ year labor warranty I� ❑ New vent i and cap ❑ year compressor warranty iJ ❑Evacuate refrigerant system pipe p ❑ Charge to manufacturer's specs ❑ Clean work area to customer's satisfaction ❑ year service agreement ❑ Meet all federal, state & local laws ❑ Condensation overflow safety switch ❑ ❑ Hurricane Fasteners for oor unit ❑ Option (below) ❑ To Investment $ Taxes $ O 117 S otal Amount $ a S Down Paymeat $ Balance Due $ Terms: Acceptance (Customer) Approval (Company) Date By Date �By — oro�--- ®G�o®o©©000c�000r—oo� c—oo®©®®coor—moo