HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 13 I a d Permit Number:
C"t]tlth
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
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential L'
Address: 3 1 �Gno n- i A b-' Ufa `-F
Property Tax ID #: 3-39-7-5 � C d � - U0 y —� _ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
V 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: $ 3 r7LJ 5- Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,e i -j M41"OUC4 A&Iaroll
Name: Curtis Sammons
Address: 01 131 u _)(� s Off'
Company: Custom Air Systems, Inc.
I y
S TnUGIe State,
City: i0p rj-L-
Zip Code: 3 (-(a Zf P Fax:
Phone No. '$ bb- ;-0- %6e(l
E -Mail:
Address: 1615 SE Village Green Drive
City: Port Saint Lucie State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail custairsys@aol.com
State or County License CAC051810
If value of construction is �>z5uu or more, a Ktwrcuty IVOULC vl %-Ulf]IIJUllI.0 II 11L ,- .�.,....
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
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/ 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 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."
Ot
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA(11 STATE OF FLORIDA
COUNTY OF ilii- COUNTY OF St k_U,,:XL
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this 1' day of f'V% _ 20_2:C> by this day of M cL Ll 20_0,0by
euRT1S 51MIva fS
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 qoricla )
No. ajG 0 5 gsq(,
r
r°s
Commission
REVIEWS
FRONT
ZONING
COUNTER
REVIEW
DATE
RECEIVED
COMPLETED
CHRISTINE B ENI
MY COMMISSION # G
EXPIRES: April 4,
.J
(Signature of Notary Public- State of Flori`crA 1��� CHRISTINE B EJ
SA s a t� 6 * MY COMMISSION #
mission No.
a� oe EXPIRES: April
Bonded Th. Budget R
SUPERVISOR I PLANS I VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
Custom Air Systems 111c. I
1615 SF Villuge (;r"" Drlvt - partSt' "Ucle' FI, 341)52
(7112) :335-32 .32 * Fax ( 772035-19"
Proposal aod Agreement I
lo)
pro"
Customer
Joh Address S;
Address
Work Phoal
City. State, Zip Acid.
W,t will furnish, install and service the equipment listed hiflOw at the price, terms and conditio" owined *a this proposal.
Equipmctlt SPeclfilqatloris
Makei.! /� lNtd
EER_ AFUE—
SEER
f! New Amp disconnect
C New w AMP 41CC-ttic SerVIC4
r-1 New low voltage Wiring
New weather irsistant NWPnwAu suttid
New reinforced equipment Pad
New vibration isolation pads
7—'-! New properly sized refrigerant lines
clean. dry ACR copper tubing
-C, Insulate refrigerant suction lin l§i
C it shell retrigerant drier0s)
,2-fvacuate refrigeram system
,;-- charge to manufacturer*$ SPOCS
,2eCt all federal, state & local law8
E! Option (below)
Ems' lrvzll energy Saving seta � tat
0 New copper wire from
'FS rake air tight plenum tralultio',
new suppiy diffuser(s)
New duct run frOM — 10
Noise reducing flexible duct conr4cwr
,:-7 Balance for Uniform ,upplly air distribution
r—, p"ide for external combustion air
New gas piping from — to
0 New vent pipe and cap
,0-`—Cjean work ama to VJ$tOM0t'6 satisfaction
PK
1ridensation W. "110", safety swillch
1110) rricaneFW(*Urs fbl° OutdOur
0----, -
x 'in bOX6 - YC&
M New corAtn"W drWrIvVAM
New nom PUMP
c4xvumsaw dr** pan
0 New high tfr=CM lit f'AW
V—r
ftwro Aar filter grill
MfXA all C044 TeqAittfal
system staft UP
Z- Corn
2!101 Pam *WTMY
1w:;or Wumt1f
YM vWnprow-, vivrrAI
YW servict AST=vXTA
—j,,,j!A) Invtanvni.
`
11� Taxes
CL
f
-Total An 4) -
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DOWVj PUMAI S-
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