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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /�-,2/'/� 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 (I' PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: /c.o o Z'a-n Property Tax ID -'Ce -j Lot No. Site Plan Name: Project Name: J DETAILED DESCRIPTION OF WORK: Block No. CONSTRUCTION INFORMATION: I Additional work to be performed under this permit -check all that apply: Mechanical _Gas Tank _Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Generator Sq. Ft. of First Floor: Windows/Doors Roof Pitch Utilities: —Sewer —Septic Building Height: OWNERAESSEE: CONTRACTOR: Name We i e a 17 e ✓E I- Name: Curtis Sammons Address: // ©v/II G Q.12Q /Soa ,LQ 17 Company: Custom Air Systems, Inc. City: - Low r .ST , Uri � State: FL. Zip Code: �E 5a2_ Fax: Phone No. J'/ S-r?CC '`,2 /6 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) If value of rnnctn.rtinn ;� t'f cnn . E-Mail custairsys@aol.com State or County License CAC051810 --- ---- -, - •----.. ....... — —.n —1-t uJcm m requireo. 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 MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: 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 COUNTY OF ;6 GLe�-� STATE OF FLORIDA COUNTY OF ilt 9eaecL The forgoing instrument was acknowledged before me this of/ day of /yo✓ 201,1� by The forgoing instrument was acknowledged before me this V day of N;n- 20 / % by � (I r T / S Sf n1 In G n-5 �U R T S 6/ ,rn meo /I 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 vy (Signature of Notary Public- State of fforicla) ,t , /r CHRiST)NE B E Commission No.CiP os2S�l6'���' f MY COMMISSION # r7 `oc EXPIRES:Apr94. (Signature of Notary Public- State of Flori tSH roe .. <i� CHRISTINE BENGL mission No.Gt� ®Sa S�6 �� MY COMMISSION �� IION#G 4 21 p�° � \ TivBudgeu 9N Na REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. Custom Air Systems Inc. (�f-- Kol)--t 1615 SE Village Green Drive • Port St. Lucie, FL 34952 (772)335-3232 • Fax ( 772) 335-1968 Proposal and Agreement Customer Name e ' ep n ` o 1l n Dy e,— Phone Date44Z�O Address a��t n at �(1'� Job Address �— City, State, Zip S4-L t )C_.' e 3 7 %—,4Ork Phones) We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal. Equipment Specifications Make ACC-b \0,1`/ I&Wel Number(s) P.I L1U --5& SEER�EER AFUE Btuh Cooling3�, avo Btuh Heating Q '"✓ CFM Installation shall include: ❑ New Amp disconnect ❑ New Amp electric service ❑ New low voltage wiring ❑ New weather resistant equipment stand New reinforced equipment pad ❑ New vibration isolation pads ❑ New properly sized refrigerant lines ❑ New clean, dry ACR copper tubing ❑ Insulate refrigerant suction line(s) ❑ Install refrigerant drier(s) ❑ Evacuate refrigerant system ❑ Charge to manufacturer's specs eet all federal, state & local laws ❑ Option (below) Terms Remove existing equipment from premises Install energy saving setback thermostat ❑ New copper wire from to ,rake air tight plenum transition new supply diffuser(s) ❑ New duct run from to ❑ Noise reducing flexible duct connector ❑ Balance for uniform supply air distribution ❑ Provide for external combustion air ❑ New gas piping from to ❑ New vent pipe and cap ($Clean work area to customer's satisfaction �❑ Condensation overflow safety switch Hurricane Fasteners for outdoor unit Jby C ec �iOL ot�� r) Approval (CApfiny) LJ New condensate arain system ❑ New condensate pump ❑ Install aux. condensate drain pan ❑ New high efficiency air filter ❑ New humidification system ❑ New return air filter grill Meet all code requirements Co5!pkte system start up ❑ year parts warranty ❑ �_ ear labor warranty ❑ ear compressor warranty ❑ year service agreement e�o,/ � Q �' . /10� 0` v ✓LvU To Invetfinent $ Taxes $ I Total Amount $ O Down Paymeat $ Balance Due $ n % u Dat�` G�,