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HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Date: d Building Permit. Application Plonning and Development Services 3uilding and Code Reguiatior, Division 2.300Virginia Avenue, Fort Pierce FL34982 Resi ential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT TYPE: j PROPOSED MAPROVI�M>f Address: o75/Ot3 Ild-If OC v7G l - 0 D Lot Na__ Property Tax ID #: Block No. Site Plan Name: Project Name: DETAILEi3_ DESCR.I.. 'T Additional work to be performed under this permit — check all that apply: Windows/Doors �PO(echanical —Gas Tank — Gas Piping — Shutters , Pitch —Plumbing —Sprinklers Generator Roof — — _Electric Sq. Ft. of First floor: Total Sq. Ft of Construction: G ? s Utilities: _Septic Building Height: Cost of Construction: $ ,_Sewer OWNER/LESSEE Name "v Name: Curtis Sammons iCustom Air Systems, Inc. Company: Address: 0� r fyl�/LOCI� l D/l� ��'% State. �G- ! 1615 SE Village Green Drive ;Address: FL City: j Zip Code: Fax: �yQ� City. Port Saint Lucie State: 772-335-1%8 I Phone No. �7a q66 67�� Zip Code: 34952 Fax: Phone No 772-335-3232 E-ail: simple Title Holder on next page (if different CAC051810 E-Mailhe LFilil�'inee Owner listed above) State or County License 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. /k.,, <, .ri_ Custom Air Systems Inc. 1615 SE Village Green Drive - Port St. Lucie, FL 34952 (772) 335-3232 - Fax( 7�7)2) 335-1968 Proposaland Agreement ��r ) l"X — t- / %� Date � (�J � �r Phone `�v ustomer Name Address 0 "t v l!�;, t U e/ 0162� Job Address City, State, Zip Ct 0,wf l✓" e r l , � 7 6' Lk Phone(s) rms and conditions outlined on this proposal. We will furnish, install and service the equipment listed below at the price, te Equipment Specifications Make Model Number(s) SEER EE AFUE__— Btuh Installation sha 1 'ncluO , J Btuh Heating ❑ New Amp disconnect �n O Remove xisting equipment from premises ElNew Amp electric servic ❑ Install ene y saving setback thermostat ElNew low voltage wiring ❑ New weather resistant equipment stand ElNew copper ire from to ❑ Make air tight lenum transition ❑ New reinforced equipment pad ❑ new supp diffuser(s) ❑New vibration isolation pads ❑ New duct run fro to ❑ New properly sized refrigerant lines ❑ Noise reducing flexible duct connector ElNew clean, dry ACR copper tubing ❑ Balance for uniform supply air is r ❑ Insulate refrigerant suction lines) ❑ Provide for external combustion air ❑ Install refrigerant drier(s) ❑ New gas piping from to ❑ Evacuate refrigerant system ❑ New vent pipe and cap to customer's satisfaction ❑ Charge to manufacturer's specs _�Condei=sat [I Meet all federal, state & aws ' B�overflow safety switch ❑Hurricane Fasteners for outdoor unit ❑ Option (below / ❑/ O III °,4 t//t Yes ❑ New condensate drain system ❑ New condensate pump ❑ Install aux. condensate drain pan ❑ New high efficiency air filter ❑ New humidification system' ❑ New return air filter grill ❑ Meet a requirements Complete system start up ❑ year parts warranty ❑ year labor warranty ❑ year compressor warranty ❑ year service agreement El Total Investment Taxes Total Amount Down Payment $ Balance Due $ Terms: Approval y) Acceptance ustomer) � � Date BY { �roo®®®®®oo©c—=roor—moo ®®�®oroe Date`' 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 which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may Please structure. restrict or prohibit such 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." t Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA {� G STATE OF FLORIDA COUNTY OF vA oLU.COUNTY OF to eca l The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of %? 20 WO by this cf day of gig 2040 by j T/ 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 Produced Type of Identification Produced (Signature of Notary Public- State of orida) (Signature of Notary Public- State of Flori 1 I Commission No. ��Str►�e�l CHRISTINE B EN rot.1...0" CHR15iiNE i3 ENG H * * MYCOMMISSION I G rlission No_ a ' �J4 My COMMISSION # �G 5 EXPIRES: �' EXPIRES: Apn7 4. �021 e� Apr! 41211 'Fos noF� Boxed nw some Nosy REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW DATE RECEIVED I DATE III COMPLETED Rev. 1