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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 4-1 1 / 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 PERMITTYPE: PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: z- ftp /1•- G��t ., ,ys«� CSP �+s. o,.:-' S'/r �✓ CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: --Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric — Plumbing — Sprinklers — Generator Roof — Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ T..= Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name /(� // ' �� Name: Curtis Sammons Address: zea // Com an Custom Air Systems, Inc. P Y� City: f 6rc State: �G Address: 1615 SE Village Green Drive Zip Code: Fax: Cit,_ Port Saint LucieFL State: Phone No. 17/— 5rf'— j�f'�3 34952 Zip Code: Fax: 772-335-1968 E-Mail: Phone No 772-335-3232 Fill in fee simple Title Holder on next page (if different E-Mail custairsys@aol.com from the Owner listed above) State or County License CAC051810 F value of construction is $2500 or more, a RECORDED Notice of Commencement is required. f 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/ CONT RAC -FOR 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 thepermit 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 STATE OF FLORIDA COUNTY OF JIs UCG_L COUNTY OF c/� �Cif+� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this � day of &C , 20_t� by this � day of Oz7_a 20-/ � by /1(if, T� 56AIImGn.SI eQRTrS S5eM/1?D�S Name of person making statement. Name of person making statement. Personally Known _� OR Produced Identification Personally Known X 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 5 S�6 ro<!�r Put?' CHRISTINE B E ISH rot; . ���`o CHRISTINE B EI Commission No. * M1'COMMISSION#G Imission No.6t� 95a 5`{6 * k MYCOMMISSION# feac EXPIRES:April4, 21 '� \oc EXPIRES:AV9, 'Fos BwxW nw Mget Na REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 211119 �000000000000000000000000000©0� Custom Air Systems Inc. 1615 SE Village Green Drive • Port St. Lucie, FL 34952 (772) 335-3232 • Fax ( 772) 335-1968 Proposal and Agreement Customer Name ! t✓� ►�! D a ✓j t ��� Phone s Date oxo maii-jsr-14 CIr Address Job Address City, State, Zip f5 t —?YC-! 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 Make Model Number(s) SEER EER AFUE Btuh Cooling Btuh Heating CFM Installation shall include: Xv.io 2T--- IVS--( Sy �"�i�•/ f/�t- Sl (i( 0 0 Q 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 ❑ New weather resistant equipment stand El Make air tight plenum transition ❑ New high efficiency air filter New reinforced equipment pad ❑ 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 ❑ Compl system start up ❑ Insulate refrigerant suction line(s) El Provide for external combustion air 11 -=year parts warranty ❑ Install refrigerant drier(s) ❑ New gas piping from to ❑ y -year labor warranty ❑ Evacuate refrigerant system ❑ New vent pipe and cap ❑ year compressor warranty ❑ Charge to manufacturer's specs ❑ Clean work area to customer's satisfaction ❑ year service agreement Meet all federal, state & local laws ❑ Condensation overflow safety switch ❑ El Hurricane Fasteners for outdoor unit q P El Option (below) ❑ Total Investment Taxes $ Total Amount $ Down Paymeat $ Balance Due $ Terms: (�l� �'�.�G+ 10,< 3� Acceptance (Customer) Approval (Company) By Date By Date �00000000000000000000000000000�