HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: <� �) � Permit Number:
' Building Permit.Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
"' Address: �'� " �
�(`��� �"� - � Lot No.
Property Tax ID #: +�ya� 1 �3 — C�""" �.
Block No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
1N*TRtJC `tfiK INIFORMATIQN-
Additio al work to be performed under this permit —check all that apply:
Windows/Doors
Gas Piping
_Gas Tank _ p g
Shutters —
_Mechanical
Electric _ Plumbing _ Sprinklers
Generator Roof Pitch
_ —
_
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:`
Cost of Construction: $ "�Utilities: _Sewer _Septic Building Height:
CON
OWNER/LESSEE:
Name too- L �` yl�k--bl(-
Name: Curtis Sammons
Address:0 I � kC14A(�ji.-�' �i
Company: Custom Air Systems, Inc.
Green Drive
State:1_L__,
City
Address:1615 SE Village
FL
Zip Code:�C S Fax:
City: Port Saint Lucie State:
C� %� � l
Zip Code: 34952 Fax: 772-335-1968
Phone No .,7 ��.
Phone No772-335-3232
E-Mail:
E-Mail custairsys@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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
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 the permit holder to build the subject structure
which is in contlict 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
..-- ^ A I Arr.,o.1cv arrnDE RECORDING YOUR NOTICE OF COMMENCEMENT:"
TVs A n f V VK LEry{!C■c %im Nw �+■ ■ v■�•« • RECORDING
- --
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
X 6
STATE OF FLORIDA
COUNTY OF c �L/1'LL
COUNTY OF o G/ram
The forgoing instrument was acknowledged before me
The forgoing instruent was acknowledged before me
3 day t r % UPS 20 90 by
this 3 1 day of R V&u) 20,-�@ by
this of c
L'(2/T'i «S J' twx0n.5
euRT1S S�h1 /?DES
Name of person making statement.
Name of person making statement.
Personally Known �_ OR Produced Identification
Personally Known �(' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of fforida)
(Signature of Notary Public- State of Florri
CHRISTINE 8
,,++ o Y CHRISTINE B
Commission NoAa 0525,46 2 ' �• MY COMMISSION#
•,���
mission No_ 41 cv p5a 5 q b 2 MY COMMISSION #
.oj � EXPIRES: Ap I
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a� EXPIRES AprI4.
1 Wv eordaan'"'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 21 //19
Customer Name v�CK f �Cf:,—> Phone
Address �?�
City, State, Zip \ �—'_ ' v `-' (10
Custom Air Systems Inc. i ff
1615 SE Village Green Drive • Port St. Lucie, FL 34952 '3 _. a
(772) 335-3232 • Fax( 772) 335-1968 V `
Proposal and Agreement 0
/' j''� C��
-) _ - � 31-
1 I Date
Job Address M
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) Tc 13Laa ` �] `�
SEER J�_ EER AFUE Btuh Cooling Btuh Heating
Installation shall include:
u
P&42A Pi
CFM
X in boxe
❑ New Amp disconnect Remove existing equipment from premises ❑ New condensate drain system
❑ 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
-Pfake air tight plenum transition filter
❑ new supply diffuser(s)
❑ New duct run from to
❑ Noise reducing flexible duct connector
❑ Balance for uniform supply air distribution
❑ Provide for external combustion air
❑ New weather resistant equipment stand
❑ New reinforced equipment pad
❑ New vibration isolation pads
❑ New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ EE cuate refrigerant system
.0" Charge to manufacturer's specs
eet all federal, state & local laws
❑ Option (below)
Terms:
Acceptance (Customer)
❑ New gas piping from to
❑ N,@w vent pipe and cap
Clean work area to customer's satisfaction
Condensation overflow safety switch
� Hurricane Fasteners for outdoor unit
Approval
By Date By
u
u
s = Yes
pan
❑ New high efficiency air
❑ New humidification system
❑ New return air filter grill
met all code requirements
�Qskte system start up
❑ year parts warranty
❑ ear labor warranty
❑ year compressor warranty
❑ ye"servi agreement
30 gg
0 I investment $
Taxes $
Total Amount $
Down Payment $
Balance Due $
Dat3 3