HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
£G1UNTY
F
L
O R I D A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Permit Number:
Building Permit Application
PROPOSED IMPROVEMENT LOCATION:
Address: _N2_4 n 1�-=- L2 1Le-'LZ S/ LLI
PropertyTaxlD#:t-%Z�
Site Plan Name: ��G�✓��YJ��1C .ir 7- jar til
Project Name:
Commercial Residential
Lot No. %
Block No.
I DETAILED DESCRIPTION OF WORK: I
6�-r7 P2� .- D-;,6% 10- S;ee-K k1o)
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:
Cost of Construction: $�
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name /V
Name: AI' M 160
Address:L&It! L . /` z, h Z 77
Company: 0 ,eayi (:�l r-
r]
City: ay- S /f cLlti° State: J_
Zip Code: %S 2. Fax:
Phone No. /-? �-� S O� �- �F%�
Address: 15 7 9/1�� /Ozem
City: -r`t Sfi \� Gt'e�
Zip Code: Lt_64,Fax: 772_
Phone No r7 Q2 ?3S -z 6
State:
-33-( )02
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
t' J1
State or County License C-A -- e
8
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.
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 "Owner/ Lessee/Contractor as Agent for Owner
a
S}5 ur'eof Contractor/License Holder
l
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5-,- Luc
COUNTY OF Z- L_ %.s c t L Goo N
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 'Z day of _,17A N u A R.y 20 ao by
this —_ day of Sg n, u A (zW 20_,),O, by
Name of person making statement.
Name of person making statement.
Personally Known a/ OR Produced Identification
Personally Known 7 OR Produced Identification
Type of Identification
Type of Identification
Produced
a'a W.Q4,_
Produced
. l K -C
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commiss G_..,� A WALSH
Florida -Notary Public
Commissi -
�,�� ��.,, A WAL H
=� ;State of Fiorida-Notary Public
,State of
REVIE
M Commission
�''��$ir�`RON ApriaQ,N�{Y�4
Expire
S PERVISOR
PLANS + TION
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f�f►t�1��2p
NGROVE
IEVIEW
EVIEW
REVIEW
DATE
RECEIVED
riD
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PLETED
Rev.12/7/19
1578 Niemeyer Circle
Port St. Lucie, FL 34952
Clean Air
Technielcoies
PROPOSAL AND AGREEMENT
A/C Sales Service Installation
By Jeffrey Almeida - Lic # CA-0058660
(772) 335-2061
Fax 335-1802
CUSTOMER NAME Mtt`-S Vi OkVOV PHONE Hai - 5" 3' 5c"'` DATE
ADDRESS LN JOB ADDRESS SAw+E
CITY, STATE, ZIPc� aT 5} l.uGl C FL_
WORK PHONE �1a3' S�0 3 5ob2
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
— 0 3 c� liC
Make t'R I!2j AiRL 'a -TOJt Model Number(s)P
SEER 1 EER BTUH Cooling 3(0t� BTUH Heating to CFM
Installation shall
include: -rid, Poc u -.. s At M N _ 5-1, �- �41� 1),9d
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
_/13emove existing equipment from premises
stall nevrV 'lot thermostat
New copper wire from to
Complete system start up
X=Yes
Make air tight plenum transition
New dehumidistat
New supply diffuser
New duct run from to
New return air filter grill
Noise reducing flexible duct connector
Glean work area to customer's satisfaction
New condensate drain system
Install aux. condensate drain pan
New high efficiency air filter
Meet all code requirements
e 0 year parts warranty
/ year labor warranty
�o year compressor
_ / year service agreement
Option (below) Alternative (below) Is (_ Is not) included in price
Installed Price
Terms:
Acceptance by: ^4 ,vim 46MQ40
Approved
Date / Z ;i.a�)-D by:
Taxes
Total Amount
0-0
$ 3,9Qv
$ /n cC,-Id e d
$
Down Payment $
Balance Due $
3 9 ctv a`'
Date: G aO