HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4o l' Permit Number:
POWD
•
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 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMEO LOCA�F�N; �
Address: i'��1D Cr .�p1e, nCl
Property Tax ID #:Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
I CONSTRUMOK INFQRttIFA'F PN:
Addlechanical
nal work to be performed under this permit- check all that apply:
_ Gas Tank _ Gas Piping _ Siutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor: _
Lot No.
Block No.
Windows/Doors
Roof Pitch
Cost of Construction: $ -�lJ Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: "
ipM FRA£TOR.
Namec— i ea-mc Ve-l6
Address: \C
City: 5� io6e Stater
Zip Code Fax:
Phone No. dI �' Sze ''�
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
E-Mail:
Phone No 772-335-3232
Fill in fee simple Title Holder on next page ( if different
E-Mail custairsys@aol.com
State orCounty License CAC051810
i
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is gequired.
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 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 i
COUNTY OF J,6- ZL Z'-C
STATE OF FLORIDA {,
COUNTY OF V ec� -
The rgoing inst�r men��t was acknowledged before me
this ( day of —1 , 2� by
I The forgoing instrument was ackn wledged t�efore me
this —Li day of aY1 20,Z�y
&- i'i LrS J�FPVInOn 5
LURT15 SA-mNo/)S
Name of person making statement.
Name of person making statement.
Personally Known A' OR OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identification
i
Produced
Produced
-s�
I
2
ry
(Signature of Notary Public- State of Florida)
� `, oitAY Pue CHRISTINE B EN
Commission No.L2Gt a�2�Y6
*� MY COMMISSION n
tO7 `o� EXPIRES:Apn74,
4 n-n6¢�RlivBndye#
(Signature of Notary Public- State of Florida
LISH roe*'.. CNRISTINE a
sa 5 b
Rwission No. * MYCOMMISS10Nft
a EXPIRES: Apn74
�
02f or", �V Bo.-mdedThruBudget M
ff�
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
2546
VMS
Custom Air Systems Inc.
�� 1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772) 335-3232 - Fax ( 772) 335-1968
Proposal and Agreement
Customer Name E 1 U100 r (21 t, C i Phone 4 b\ - 5Zq — 181 2) Date I - Z' -Z o
Address 3�!Alz) r,d��1' Z) Z Job Address
City, State, Zip �� l �i 2-6- ` �`�'t-- 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 Pq�� at re' Model Number(s) Frc)(4a`
SEER EER AFUE Btuh Cooling
Installation shall include:
Btuh Heating d \�w CFM
X in boxes = Yes
❑ 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 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
0 New vibration isolation pads
❑ New duct run from to
❑ New return air filter grill
❑ New properly sized refrigerant lines
❑ Noise reducing flexible duct connector
_0--geet all code requirements
❑ New clean, dry ACR copper tubing
❑ Balance for uniform supply air distribution
2--Complete system start up
�Ynsulate refrigerant suction line(s)
❑ Provide for external combustion air
❑ year parts warranty
refrigerant drier(s)
ElNew gas piping from to
❑ 1_ year labor warranty
,GXInstall
;'!^Evacuate refrigerant system
❑ New vent pipe and cap
❑ year compressor warranty
El' —Charge to manufacturer's specs
❑,.Clean work area to customer's satisfaction
❑ year service agreement
25�meet all federal, state & local laws
ia'Condensation overflow safety switch
❑ asjec t'J LO,,X� 20-a'
It S
,0'Hurricane Fasteners for outdoor unit
fl �
Investment $_/ ►► )w
❑ Option (below)
❑
Total
Se .,;C<Z- ` Iy1'� %
. d b n,��
c� UG'3 sb
Taxes $
IV L/ I Total Amount $
I Down Payment $
v ^ ' Balance Due $
Terms:
Acceptance (Customer) Approv 1 (Company)
a 1-26
By Date y Date 9