HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b' a 1 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:
Address:
Property Tax ID #:a —
Site Plan Name:
Project Name:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
Add jtional 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:
Cost of Construction: $ /`' ;7
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR: -
NamegOr�41i'* 441
Name: Curtis Sammons
-(,c,S�"►'�
Address: ��I Tr-► M f-0- I-�C2t
Company: Custom Air Systems, Inc.
City: CG I - -1 3 U' State: 2
Zip Code: (7 Q15- / Fax:
Phone No. L(O ( C(� %- a.s
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
iI value or construction is >LbuU or more, a KtCUKUtD Notice Ot 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 pp
COUNTY OF �/,� oC GGG'
STATE OF FLORIDA (,�
COUNTY OF s tL eL_
The forgoing instrument was acknowledged before me
this 93 day of OG`h_)bPs 20- by
The forgoing instrument was acknowledged before me
this � day of CMG_-'Cb e- 20_fj by
T,5 5�7MX0nS
eta T1S 6/lnfVO/)5-
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification /
Personally Known k OR Produced Identification
Type of Identification
Produced
Produced
I
22,
(Signature of Notary Public- State of Florida)
'PAY ray
Commission No. �Gt 05 2S�16 r° • CHRISTINE B E
* •� f MYCOMMIMN#
`". EXPIRES: AP14.
•�
(Signature of Notary Public- State of Flori 1
°t I CHRISTINE B
iSH / r o
iiission No. C, (^p Bsa S q 6 * MYCOMM►SSK)N#
21 EXPIRES: Apnl
of P� Ba+ded Ttru Budget
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 211119
�' /h, 1r. , r
K)C J-e
Custom Air Systems Inc.
0
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772)335-3232 • Fax( 772) 335-1968
-P,,,�-. yCCA- 4�Dr -goa 5
Proposal and Agreement
y01 Gy '7
- 9a 65
pp
Customer Name R()r%&k1 W� 414
chic
Phone y61— 00*7
- 1 Date `o
Address ga 13 �h k o
I Job Address
City, State, Zip Q—C--,L I f-&611
Work Phone(s)
We will furnish, install and service the
equipment listed below at the price, terms and conditions outlined on this proposal.
Equipment Specifications
Ad co AT R C
Make Model
Number(s) PA T �01
�
SEER _ EER AFUE Btuh Cooling `'f�j D25 C> Btuh
Heating ��K CFM �S
Installation shall include:
�i
O
X in boxes = Yes
❑ New Amp disconnect
❑ Remove existing equipment from premises
❑ New condensate drain system
❑ New Amp electric service
❑ Install energy saving setback thermostat
❑ New condensate pump
❑ New low voltage wiring
❑ New copper wire from to
❑ Install aux. condensate drain pan
D New weather resistant equipment stand
❑ Make air tight plenum transition
❑ New high efficiency air filter
❑ New reinforced equipment pad
D new supply diffuser(s)
❑ New humidification system
❑ New vibration isolation pads
❑ New duct run from to
❑ New return air filter grill
❑ New properly sized refrigerant lines
❑ Noise reducing flexible duct connector
❑ Meet all code requirements
❑ 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
❑ 10 year pans warranty
❑ Install refrigerant drier(s)
❑ New gas piping from to
O 1 year labor warranty
❑ Evacuate refrigerant system
❑ New vent pipe and cap
❑ 10 year compressor warranty 01'¢s, A,
jj ❑ Charge to manufacturer's specs
❑ Clean work area to customer's satisfaction
❑ year service agreement
IJ ❑ Meet all federal, state & local laws
❑ Condensation overflow safety switch
❑
❑ Option (below)
❑ Hurricane Fasteners for outdoor unit
❑
Total Investment $ 6 io v
�
lJ
Taxes $
Total Amount $
Down Payme.tt $
�l
Balance Due $
�
Terms:
1 Acceptance (Customer)
Approval ( p y)
1 By
Date By
Date �