HomeMy WebLinkAboutBuidling PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
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 —Z
PERMIT TYPE: � % l/Ae-1
PROPOSED IMPROVEMENT LOCATION:
Address: q INL E 5 T A /4 CAI e 1^v/
Property Tax ID #: 1? 1 8 Dao /0019? / %gg�{-L- tD 00669. Lot No.
Site Plan Name: L' el UC l; E re -6 � Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK:
AG C
CONSTRUCTION INFORMATION:
I LE -7f-a JL
Additional work to be performed under this permit -check all that apply:
_t l0Iechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
CFO
Cost of Construction: $ 93J Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 6V 14 1J ✓nolRRIS
Name: ge fC ALMellOh
Address: q PvE6-r2A Pil
Company: (fVA,y Ae2 -reCH "Lc�IES
City: PO A• 5-t Lu c rt State: F�--
Zip Code: 399 5_�2 Fax:
Phone No. _74>-'9- - 67y 9 7y
Address: 15 -7 /Ul EM E)6�&
e 12c�2
City:?ocr s-} L,)ctl-
Zip Code: �l 52r Fax:
Phone No `77a 3:35' aob�
State:��
1
315-
E -Mail:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail C'C6 A�-J t S -7 k A '40 c. • coM
State or County License CA C U S 8 66o
if value of construction is $2500 or more, a RECORDED 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."
Signa caner/ Lessee/Contractor as Agent for Owner Si ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5� Luc i GO 0 -VA COUNTY OF Z- L u c i(Coo
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge -4 before me
this j day of i300t r 3£a- 20)_ Q by this 'g- day of iVOUC:rn SE/l- 20_/ 1by
Name of person making statement.
Personally Known V --"OR Produced Identification
Type of Identification
Produced
Name of person making statement.
Personally Known ✓/ OR Produced Identification
Type of Identification
Produced
a),2ML bib, ( K
(Signature of Notary Public- State of Florida } (Signature of Notary Public- State of Florida }
Commiss 5ANDHA WALSH Commissi SANDRA WAL H
.`y4 ;State of Florida -Notary Public ;_� --State of Florida -Notary Public
°` ` RON CApr IaOJPN1%4 p�HSlFvltvv
PERVISOR PLANS TION C t P 1fe NGROVE
REVIE ��n� ���``
REVIEW EVIEW
DATE
RECEIVED
DATE
COMPLETED
1578 Niemeyer Circle Clean Air (772) 335-2061
Port St. Lucie, FL 34952 Fax 335-1802
Techncicaies
PROPOSAL AND AGREEMENT
A/C Sales Service Installation
By Jeffrey Almeida - Lic # CA -C058660
CUSTOMER NAME mh'l'S
ADDRESS Cf /--t1e5 C °`,L- C ►C
CITY, STATE, ZIP
PHONE %C, G, 74-�r ���c DATE ///—,A_//,9
JOB ADDRESS
WORK PHONE
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on all pages
of this proposal.
EQUIPMENT SPECIFICATIONS
Make FA('_(.)&o (` Model Number(s) p? a -e _ 0 3
SEER 1 EER BTUH Cooling BTUH Heating Com- CFM
Installation shall
include:
,X/
New Amp disconnect
New low voltage wiring
New reinforced equipment pad
New vibration isolation pads
New properly sized refrigerant lines
New, clean, dry ACR copper tubing
Charge to manufacturer's specs
Insulate refrigerant suction lines
Install refrigerant drier(s)
Evacuate refrigerant system
Remove existing equipment from premises
Install new e L I thermostat
New copper wire from to
_Complete system start up
Option (below)
Terms
Acceptance by;
Date
Alternative (below)
X=Yes
_/lake air tight plenum transition
New dehumidistat
New supply diffuser
New duct run from to
_New return air filter grill
Noise reducing flexible duct connector
Clean work area to customer's satisfaction
New condensate drain system
Install aux. condensate drain pan
New high efficiency air filter
Meet all code requirements
X /0 year parts warranty
sir Lyear labor warranty
N"' le year compressor
_year service agreement
Is ( _ Is not) included in price
Approved
by:
Installed Price $ 3
1;111
Taxes $ � 7 S
Total Amount $
Down Payment $
Balance Due $ ? C C
Date: �-� j