HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� "�� Ofo Permit Number:
ICOUNTY
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
PERMITTYPE:
I PROPOSED 1WRQVFMENT1> k +l
C7
Address: 07 / y l�-i, C��� li0 C r
Property Tax ID Lot No.
Site Plan Name: Block No.
Project Name:
DETAI!€D; D£SLR�F'3iFit3±:K. _
i oil PacCgg:� oi'7i f /0 KC J �4Pa�
lySeer
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction
Cost of Construction: $ _
4350 -
Sq. Ft. of Firs# floor:
Utilities: —Sewer, _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
Name nrJe 7e_ ;1IeA 2
Name: Curtis Sammons
Address: aQW F1'&-Jho YY-6-Y r it
Company: Custom Air Systems, Inc.
City: pDr+ 5-E I oci e. State:
Address: 1615 SE Village Green Drive
Zip Code: Fax:
City: Port Saint Lucie State: FL
Phone No. g7t—(05&0
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
E-Mail custairsys@aol.com
E-Mail:
Fill in fee simple Title Holder on next page ( if different
State or County License CAC051810
from the Owner listed above)
IVO — W6Wux1 uLtWfl ID ,7LOW Ur MUre, a KCLUKUtU Notice oT C.ommencement 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/license Holder
STATE OF FLORIDA
�L{.CLC�
STATE OF FLORIDA GG
COUNTY OF
COUNTY OF
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 012_+ObeZ 20,10 by
this day of C)C+c ber— 20a0 by
(Zit- T(s ����lfnGn-
-lI(k'T1y fY1G1175
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��3
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florid4
�t rr,� 20{►�Y CHRISTINE B EN
Commission No tl� �i 5�55G� * � MYCOIIMISSIONtS
ISH , e� 20�* ` CHRISTINE S EJ
mission No. " (; 05a S 4 � 3 }` MY COkMISSION S
a. c EXPIRES: A;4
D PiRES: Apn14.
21 F`oP�v Eo e±ed itw Budget
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 211119
`s
0 Custom Air Systems Inc.
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772)335-3232 • Fax (772)335-1968'/
Proposal Agreement
P and
Customer Name nt' E►'� Phone 77 -2, - t-6 Spa Dateoc-�O�xr %9 v
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DAddress e i'J C-1 e) Job Address
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City, State, Zip 1` - IS- 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
f[
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OMake n Model Number(s)
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SEER EER AFUE Btuh Cooling Btuh
L
Heatingg--
Installation shall include:
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❑ New Amp disconnect ❑ Remove existing equtpment from premises
Lin,
❑ New condensate drain system t9
❑ New Amp electric service ❑ Install energy saving setback thermostat
❑ New condensate pump O
❑ New low voltage wiring ❑ New copper wire from to
❑ Install aux. condensate drain pan n
❑ New weather resistant equipment stand ❑ Make air tight plenum transition
❑ New high efficiency air filter LI
New reinforced equipment pad ❑ new supply diffuser(s)
❑ New humidification system
❑ New vibration isolation pads ❑ New duct run from to
❑ New return air filter grill
New properly sized refrigerant lines ❑ Noise reducing flexible duct connector
❑ Meet all code requirements
❑ New clean, dry ACR copper tubing ❑ Balance for uniform supply air distribution
❑ Samplete system start up
❑ Insulate refrigerant suction lines) ❑ Provide for external combustion air
U year parts warranty
❑ Install refrigerant drier(s) ❑ New gas piping from to
year labor warranty
Evacuate refrigerant system ❑ New vent pipe and cap
�� year compressor warranty
❑ Charge to manufacturer's specs ❑ Clean work area to customer's satisfaction
2-�- year sej� ice a eem�,
Ell A
❑ Meet all federal, state & local laws ❑ Condensation overflow safety switch
(� 7 Lf,Pav
❑ Hurricane Fasteners for outdoor unit
0
❑Option (below) ❑
Total Investment $
n
Taxes $
Total Amount $
%10
3 T 3 S
Down Payment-5. G J C
Balance Due $ 2�
Terms:
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y Date By
Date
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