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HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE Permit ND mber: Date'. I a'C4 • I�cation Building Permit.App Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential ai Phone: (772) 462-1553 Fax: (772) 462-1579 COtY1t11erCl PERMIT TYPE: PROPOSED IMPiif?1lEIV[ENT $a Address: 17 _ Property Tax ID #: oZ303— 2 11 — Lot No. Block No. Site Plan Name: Project Name: DETAILED.DESCRi ` ©�W K GlltC- /y�� El1t� ro� /yS�- 9✓ice /©%f✓ L�- Additional work to be performed under this permit— check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters LIL Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ �' Uti Generator Sq. Ft. of First floor: Windows/Doors Roof Pitch lities: Sewer _Septic Building Height: OWNER/LESSEE: Name -T, /V, 2�S IAddress: � (O 6? e V a 1,5 S City: C.O\/ e r) Stater Zip Code: C98/ `P Fax: Phone No.771-/- q51-1- 7(e 3 Li E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Curtis Sammons Company: Custom Air Systems, Inc. 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 custairsys@aol.com State or County License CAC051810 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 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 in any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such which is contlict with 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, rooms and accessory uses to another non-residential use accessory structures, swimming pools, fences, walls, signs, screen "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 Contractor/License Holder ure o Owner Lessee/Contractor as Agent for Owner Signature / STATE OF FLORIDA (7 p STATE OF FLORIDA COUNTY OF & d�Glf'Y COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of Opril 20 26by this 2.q day of IR T i ` 20 Eby J R n1 X G n.5 eu R TI S S/3h1 is?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 orida) (Signature of Notary Public- State of Flori CHRISTINE B V�'Y • CNRISTINE B 05254(6 �...., Commission No.�Gt iiIYCOMMISSION� issionNo.aagSa5`�6 ' EXPIRES: n EXPIRES:AprB ri �o EXMRES:Aprl4. t *�osi�°�`o ftWadTh k4W No REVIEWS FRONT ZONING SUPERVISOR PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. �00®®��00©O©OOOOODO©®O�OOODO®®� 0 Custom Air Systems Inc. 1615 SE Village Green Drive - Port St. Lucie, FL 34952 0 (772) 335-3232 - Fax ( 772) 335-1968 0 0 Proposal and Agreement Customer Name Phone Date Address Job Address City, State, Zip 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: X in boxes = Yes ❑ New Amp disconnect ❑ Remove existing equipment from premises ❑ New condensate drain system D❑ 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 ❑ 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 ❑ Complete system start up ❑ Insulate refrigerant suction line(s) ❑ Provide for external combustion air ❑ year parts warranty ❑ Install refrigerant drier(s) ❑ New gas piping from to ❑ 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 ❑Option (below) ❑ Total Investment $ Taxes $ Total Amount $ O Down Payment $ 0 Balance Due $ Terms: Acceptance (Customer) Approval (Company) By Date By Date