HomeMy WebLinkAboutPALO RESIDENCE PERMIT APPLICATIONI�.
ALL AppLIC LEI FO M ST BE COMPLETED hR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Planning on Develo Building Permit Application
pment Services
Building and ode Regulation Dlvislon
2300 Virgin! Avenue, Fort Pierce FL 34982
Phone:(77 462-1553 Fax: (772)462-1578,r
Commercial
PERMIT A PLICATION FOR: mercial
Residential
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Address:MV
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Legal Desclrip on; p� rt; I �i ( ✓lei
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Property Tax #: 13o1b-Sov-o)8t�'Gbo-
Site Plan Na
L t No.
Project Name q B Y Sim s
_ Bli ick No.
Setbacks F nt
Back:
lRight Side:
e; � Left Side: 176,
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�iOn wi}i.1-5
=u unaerthis peY t-c ecca14
VAC Gas Tank eppry'
❑Gas Pipioffifflimm
ng _ Shutters Electric ElPlumbing S ii; Wind(
Total Sq. Ft of onstruction; p Itiklers Generator
I„i Roof
C x S Ft. of First Floor:
Cost of Constr ction: $ y SS —_
Utilitiest] ewer❑Septic Building
IVdme
Address: I I 7� 1 -h Name:
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City: o! P;aCompany: dr WI
Zip Code: State: r-L_ hn Y
q 5) Address: b8i)
— 165. 45
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from the Own r listed above) page (if di ,:rent E-Mall: 1�1 la :u I-!
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If value
State or County License: CO'S(,
of const uctlon is'2500 or more, a RECORD
y,Notice of commencement is required. 1
it i.;
Name:
14SURTGA48E COMPANY: Not
Address:
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city:
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Zip:
Phone: -- State;
Ctty:
FEE SIMPLE
Name:
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BONDING COMPANY:
Address:
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beF oVthe (IproPerty. A Noticeof Commenentmust brerorded and posted antheeom ancinlbn' If fro tend to o6Mn fmancffr cnrtwlt tslltRlendar nr�nrsu�dinY
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B212 Theayepy
REVIEWS FRONT ZQNtNG SUpERVISQA PlAN5 VEGETATION SEATUBTLE MA
COUNTER REVIEW REVIEW REVIEW R
DATE- EVIEW REVIEW R1
INITIALS
such
2021
License Numbers:
Fort Pierce Service Center CAC05
6774 CAC057407400
6811 Heritage Dr • Port Saint Lucie, FL 34952 • Phone: (888) 237-7070 CFC056867
CFC032576
ES0000336
EQUIPMENT PROPOSAL
PROPOSAL SUBMITTED TO L . ANCr6L CONTRACT# ;000 5I SALESPERSON �`^ DATE
STREET I CITY, STATE AND ZIP CODE L
E-MAIL: PHONE # NOTES ll Vv
OPTION 1
OPTION 2
MANUFACTURER:
t:
!��5)
AH MODEL:
R
CU MODEL:
' 7r)* j
MOTOR
..
COOLING STAGES
SEER
L
TONS
HEATER
SUBTOTAL:
W. r1(2
OTHER DISCOUNTS:
�- d 0,CV 00P3
TOTAL INVESTMENT:
eh1 6--
Installation shall include:
ew reinforced equipment pad
V'econnect to existing lines
ermit included
Ef Install new thermostat
Y ❑ Jnstall new H-stat
� Vertical ' = ❑ Horizontal
Ater Rack ❑ Stand
❑ 2nd Pan ❑ Vert ❑ Horz
❑ Hanging ❑ Attic ❑ Shelf
❑ UV paint
Additional work to be performed
&Breaker Brand 2 Size
reaker Brand~ Size
ff Hurricane Brackets or Strapping
❑ C,enugated pipe ft.
et all code requirements
omplete system startup .' '
IT /0 year parts MFG warranty .
��- year labor BFS warranty
❑ year maintenance
❑ Crane service
Installation does not include any duct work or line set unless specified on proposal.
Drain cleaning or old line sets are not guaranteed. Maintenance must be performed
at least once a year to system to honor part and labor warranty.
Customer responsible for any condo association approvals on changes to HVAC systems.
MethoFhe7ck
Accepted:
O Visa O Master Card OAmerican Express O Cash O Financing O Deposit
Card number
Exp. date Security Code
Authorized Signature Note: This proposal may be withdrawn by us if not accepted within 30 days
Billing Address
Payment in full is due upon startup —All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices. BFS will not be responsible for property damage when removing or replacing
youraircondilioning system. Including but not limited to attic access, staircases, floors, him, wall, etc. Any alteration ordeviation from above specifications involving extra costs will be executed only upon written orders, and will become anextra charge
over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, and other necessary insurance. Ourworkers are fully covered by Workmen's Compensation Insurance.
Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are hereby lure
a4 c,� end. ,You are authorized to do the work as s�ectfied. P ayment w!II be made as outlined above.
D`a'of" X�ab'een Signature
i-:! sales are final with no ad iustmenis cr refunds. 10yr MFG Parts Warranty if registered by customer only applies to original purchaser.