HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / ������ Permit Number:
Building Perm it.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 IMPROVEMENT LOCATION.
Address:
Property Tax ID #: �� l� QdC� ✓ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION.OF ORK:
'/.Fo r i' lee_ 3 6 N
I Seer l Cz,, Carl � 'f 16 J<Ikl
v:
CONSTRt)CT 011 ,INFORMATION;
Additional work to be performed under this permit - check
all that appl
`Mechanical Gas Tank _ Gas Piping
_ Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers
_ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
II L -7 J (�
Cost of Construction: $ ` 4 ZS 10 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CflkfkA&OR: ;
Name tIctl) e—IC
Name: Curtis Sammons
Address: 17,Sq 5+6r1e-QbrWr,
Company: Custom Air Systems, Inc.
City: ;e_ State:
Add ress:1615 SE Village Green Drive
Zip Code Fax:
City: Port Saint Lucie State: FL
Phone No. rn L16
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
from the Owner listed above)
State or County License CAC051810
I
If value of construction is $2500 or more, a RECORDED Notice of Commencer► nt 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 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."
i
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA G
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this��L day of5eP{- � t' -C_(U 20Z�by
this6),Ydayof ' p�{YY�I�E,C 20ZUby
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 fiorida)
(Signature of Notary Public- State of Florio a
� o{�Y Put CHRISTINE B
Commission No.L2(st E'S � b * 7 ?AYCOMMISSIONS
20�* p. �0tr� CRRISTINt HENI
B nission No. -,Ly �sd ��6 * MYECOMMISSIONi?
XPIRES: APB
EXPiRE$:Apta4,
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
I
COMPLETED
ev.
0 Custom Air Systems Inc.
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772)335-3232 • Fax( 772) 335-1968
Proposal and Agreement Ge l - C� 7a� S 7l-
0 i�.`�M �
Customer Name P� fe � T RP I G � Phone C z fa / L1,99 ly 7 al Date�A
I I
Address I '1 5 " — Y6,r_122 X De- Job Address
City, State, Zip r0r4_ to el-e-e FL 34446'_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 A LCQ3- I r P Model Number(s) I /81 � 0 3 /6 .
SEER_ EER AFUE Btuh Cooling Btuh Heating CFM
❑ New Amp disconnect
❑ New Amp electric service
❑ New low voltage wiring
❑ New weather resistant equipment stand
New reinforced equipment pad
❑ New vibration isolation pads
O New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
O Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ Evacuate refrigerant system
❑ Charge to manufacturer's specs
IV Meet all federal, state & local laws
O Option (below)
czq- t ( 6
boLjot4-,
Terms:
,f Remove existing equipment from premises
❑ Install energy saving setback thermostat
❑ New copper wire from to
Make air tight plenum transition
❑ 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
O New gas piping from to
❑ New vent pipe and cap
/Clean work area to customer's satisfaction
❑ Condensation overflow safety switch
I& Hurricane Fasteners for outdoor unit
s(Z/-V<<(
ViL,-,P
By A,�—
X in boxes = Yes
O 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 all code requirements
, Complete system start up
year parts warranty
year labor warranty
❑ year compressor warranty
❑ year service agreement
❑ p
Total Investment $ �y 4
S%
Taxes $
Total Amount $
Down Payment $
y e' Balance Due $ s
Appro (Co any)
Date �i O By L4 Date