HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L� ��- 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
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 7a 7 k �-5h or� (f h,
Property Tax ID #: So _ dj,-)� - OCR - Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
L-&chanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ _�.5
- -
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 0,P QtP'
Name: Curtis Sammons
Addres a 3 Q N i On 5+
Company: Custom Air Systems, Inc.
City: 1 O r�-gPfA ou-�-Y) State:
Zip Code: C) 2?> ( Fax:
Phone No.
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
n vague or construction is >/Suu or more, a KtCUKDtD Notice of Commencement is required.
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_ IF YOU -INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA 1
COUNTY OF A zuezz,
STATE OF FLORIDA
Jt
COUNTY OF yeaef _
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 6C {-61� 20 /� by
this-Q" day of 20 1 �lby
1"'Cih!/S S�nIMGnS
C�l.�RTlS 6_
eMh?D1)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
(Signature of Notary Public- State of fforicla)
(Signature of Notary Public- State of Flori
�..
,tp ,` p CHRiSTINE B E
Commission No. C752546 r ' I
* * MY COMMISSION M
rot,.. C, CHRISIINE B
mission No. Gi * k MYCOMMISSION/
m�
t0A EXPIRES: Apn14,
EXPIRES: Apr1
21 °
`O�
Bonded Tlru Budget No
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Custom Air System Inc
1615 SE Village Green Dr, Port St. Lucie, FL
34952, 772-335-3232
12198 County Rd 512, Fellsmere, FL 32948,
772-571-1080
AfterHours7723590351
customaironline@gmail.com
Invoice
DATE
.. ___ .............._... _......
10/21 /2019
INVOICE#
.................
20269
TERMS
NET 30
DUE DATE
11/20/2019
BILL TO SERVICE LOCATION
RON & MARY RAPOSA i RON & MARY RAPOSA
239 UNION STREET 9248 SHORT CHIP CIRCLE
PORTSMOUTH RI 02871 PORT ST LUCIE FL 34986
(401) 225-0702
JOB# DATE PO/REF# DESCRIPTION
110548 10/21/2019 ESTIMATE 401-225-0702
Completion Notes: ESTIMATE TO REPLACE SYSTEM
CHAMPION 3.5TON 14 SEER HP 5 KW HEATER
5250.00
Job Charges Qty Rate Total
Job Total $0.00
PRE -WORK SIGNATURE
10/22/2019 10:14 am
......................
POST -WORK SIGNATURE
CUSTOMER MESSAGE Invoice Total:
Thank you for your business Deposits
i
Payments (-):
Total Due:
$0.00
$0.00
$0.00
$0.00