HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
•
Planning and Development Services
Building and Code Regulation. Division
2.300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Permit Number:
Building Permit Application
Commercial Residential
PROPOSED IMPROVEMENT tQCATWINI- -
Address: '7V/z� 0, an f,- /ape 1/0�
Property Tax ID n: ci5,2a – 6 C S-- 00.2,1- OpD ' 9 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED- DESGRf TfON O.P V oRy
l ! l c �� 1 ��(C `o r• / S Sec ! l ��i �!`S' 7 f ff
CONSTRUCT. Off WFORMATION
e I
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: $ y.2 n
Sq. Ft. of First floor:
Utilities: —Sewer _Septic Building Height:
OWNER/L.ES5EE:3fat£{}R: i
Name "]U/% Name: CUtsSammons i
Address: 67!f�z !^/�iv,sa Ll Company: Custom Air Systems, Inc.
City: Q/�nr r%��ld State: Address: 1615 SE Village Green Drive
Zip Code: Fax: City: Port Saint Lucie State: FL
Phone No. %9.01 -&2,? Zip Code: 34952 Fax: 772-335-1%8
E -Mail: Phone No 772-335-3232
Fill in fee simple Title Halder on next page ( if different E -Mail custairsys@aol.com
from the Owner listed above) State or County License CAC051810
11 vdWe OT consirucuon is Z�Lbuu 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.
j SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I
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:
OWNEK/ LUN TRACTOR 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 zCCG_�
STATE OF FLORIDA
`l,6
COUNTY OF St V f l_
The forgoing instrument was acknowledged before me
this day of
The forgoing instruent was acknowledged before me
��rYC
20�P by
—
this _& day of 20 a20 b y
_
,I_1(Z T/ s J� W X 61 n_5
�'GI R TIS 5/y lyj,,�/) 5-
e of person making statement.
Name of person making statement.
Personally Known J� OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Korida)
(Signature of Notary Public- State of Flori
'/ 20:� �, CHRISTINE 6 EN
Commission No. 40, o52S�16 # MYCOMMISSION #G
rot; .�0�,CCHRISTINE 8 EJ
mission No. 95a 546 * MY COMMISSION#
EXPIRES:
EXPIRES: Apra 4,
21P 0 April
Bonded T1vu Budget Nc
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
idi
or-� AlcA&-
Custom Air Systems Inc.
VIUAItt (';rVv" Drive *['art St, j'Ucje' FI -14"-
(772) X35-3232 - Fax(77Z)33
5-1968
proposal and Agreeme"It
custoCustomer Varne—k-44LA&L/4 Phone
Address SO
7
City. state, Zi Work Phonc(s)
14'e will fumish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
Equipment Specifications
.Make Model Number(s)
--40—SEER EER _ AFLIE-- --Btuh Cooling Btuh Heating C FM-�
Installation shall include: 2�1
C New — Amp dismnnect
` New — Amp electric service
r-- New low voltage wiring
C'
"I New weather MsIstant equipment suuw
C N-ew rcinkrced equipment pad
C New vibration isolation pads
,vew properly sized rdrigerant lines
�7- New clun. dry ACR copper tubing
0 Insulate refrigerant suction line(s)
0 Install refriScrant drierfs)
Evacuate rurrigcmt systern
is Charge to mariuracturet*s specs
Meet all fiedcraj, state & local laws
Option
Remme existing equipment from premises
Instag, ene.V, saving setback thermostat
New ctqTer wire from — to
Make air right plenum transition
nese supply diffuser(s)
Cl New duce run from — to
C Noise reducing flexible duct conflOCtOt
[7, Balunce for uniform supply air distribution
pTm dlc
for external combustion air
�7 New gas piping from — to
C New vm pipe and cap
D Clean work area to cusjomr's satisfaction
El Condensation overflow safety switch
C Hurricane Fasteners for outdoor unit
— X in boxes = Yes
E New condenswe dram system
New condensate puM
j
Install aux. condensate drain Pan
0 New high efficiency air filter
El New humidification sYs-A-M
u New return air filter 9,fill
0 Meet all code mquircments
-I Complete system start up
year parts Warranty
year labor varranty
Year compressor warranty
C_year service agreernent
Total Investmcm
:20
V. -5 ,
Taxes S
Tarot Amount S--- --
Dow-n Payment S
Balance Due S