HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /6 ' 719 Permit Number:
COUNTY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: g
Address: Fw /� )Znzta'y
Property Tax ID#: ,33a7'&I-Q63-1_,2DO',3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
j CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
�/r�O�
Cost of Construction: $ 75
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Pn
Name: Curtis Sammons
Address: 13& HUAIV -4
Company: Custom Air Systems, Inc.
City: State: LiF}
Zip Code: O L 00 Fax:
Phone No. _717 2 - 8d 8- �D 0
Address: 1615 SE Village Green Drive
City: Port Saint Lucie State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail custairsys@aol.com
State or County License CAC051810
- -- - a wnwcu i.uume vi commencement is regwreG.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review 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 with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING 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 JOB SITE BEFORE THE FIRST INSPECTION. F YOU INTEND TO OBTAIN FINANCING, CONSULT
WIITH YOUR LENDER OR AN ATTARNFY RFFnDF DFrnDrvmr_ vnr in wnT..-c 9%= �.....� n
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF XY
STATE OF FLORIDA , �i
st
,r(��a,
COUNTY OF _ oel/jiC
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 7day of D CT 20 I4 by
this day of OC-r .20_ji by
/'�RTlS JS wx0rt_S
eu)?TIS %5l, 1lyI ?/)S
Name of person making statement.
Name of person making statement.
Personally Known _� OR Produced Identification
Personally Known .' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
J
(Signature of Notary Public- State of fforicla)
(Signature of Notary Public- State of Flori
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�!"iI $ 2.Sfi6 �° •, B
Commission No. * * M' 10N#
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n No., t a O5a S 4 b * �, I�rcollrrassaNt
EXPIRES:Api4,
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
PV
SALES * SERVICE * INSTALLATION. CAC0518
1615 SE. VILLAGE GREEN DR. PORT ST. LUCIE FL.
335-3232 465-0559 562-277 7 FAX (772) 33`
CARRIER * RHEEM * GOODMAN * TRANE * AIR CONDITIONERS
KITCHENAID * WHIRLPOOL * APPLIANCES
19 : 4 3
NAME : HOUSE CHECK
PHONE: 772-828-3200
FAX:
EMAIL: tom@housecheckfl.com
JOB NAME/ADDRESS: CLARK RESIDENCE, 9211 WENTWORTH LN, PSL 34986
HAS 3 TON HEAT PUMP SYSTEM. AIR HANDLER CLOSET. LIMITED SPACE. SIEMENS BREAKERS,
AMP FOR A/H. 36 X 36 SLAB AREA, HEIGHT OK.
WE PURPOSE TO: REPLACE EXISTING AIR AND HEATING SYSTEM.
BID INCLUDES THE FOLLOWING.
1. 3 TON RUUD HEAT PUMP SYSTEM, 7/8 KW BACKUP HEAT STRIP (SEE OPTIONS BELOW)
(EQUIPMENT QUOTED IS BEST FIR FOR AIR HANDLER AREA AND SLAB)
2. CONNECT TO EXISTING REFRIGERANT LINES (FLUSH LINES)
3. CONNECT TO EXISTING HIGH AND LOW VOLTAGE WIRING. (BREAKERS AS NEEDED)
4. DIGITIAL THERMOSTAT
5. PERMIT (INSPECTION BY BUILDING DEPARTMENT REQUIRED)
6. CONNECT TO EXISTING DUCT SYSTEM
7. CONDENSER TIEDOWN BRACKETS
8. ONE YEAR LABOR WARRANTY
9. FIVE YEAR RUUD PARTS WARRANTY.
10 YEAR RUUD PARTS WARRANTY TO ORIGINAL OWNER IF SYSTEM IS REGISTERED WITH
MANUFACTURER WITHIN 60 DAYS OF INSTALL. 10 YEAR PARTS WARRANTY DOES NOT APPLY TO
RENTAL PROPERTIES.
11. FIVE YEAR CHEAT STRIP WARRANTY. (REGARDLESS OF REGISTRATION)
R �1�4/S SYSTEM. iRPl4 8„ 1�3617�_
'0 �� SUM OF : 4 , � 'INITT •
RUUD 3 TON 15 SEER HEAT PUMP SYSTEM. RP1536, RH1T3617
FOR THE SUM OF: $ 4,975.00 INITIAL
KR�t7Oi7$
1,240 00?LII5 TAX INITIAL
QUOTE GOOD FOR 30 DAYS. TO BE PAID: AT TIME OF SERVICE.
ACCEPTED. .�J/�^....: �.... SIGNED .........................
JAMES JARVIS
�`" CUSTOM AIR SYSTEMS INC.