HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 '30 w Q Permit Number:
•
Building Permit.Application
Planning and Development Services
Building and Cade Regulation Division
2,300 Virginia Avenue,Fort Pierce FL 34982 I
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: I
f
( PROPOSED I .tOW. Mg .
Address:_3` 0 I 2 Do sa � C .
Property Tax ID#: 3 q 9-5- ( D! " 0/(U L-1-000'S Lot No.
Site Plan Name: Block No.
Project Name:
-
DETAIL�D DESICR
ri I
CONST110Clr O 44NfUt�
Additional work to be performed under this permit-check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters `Windows/Doors
Electric !Plumbing _Sprinklers _Generator ,Roof Pitch
Total Sq. Ft of Construction:f ! Sq. Ft. of First floor:
Cost of Construction:$ f 1 3� S Utilities: —Sewer _Septic Building Height:
OWNER/i-M E.:
Name_Pv)berg- 4 mc�r5kA T01�//CO Name: Curtis Sammons
Address:((p7g-O -St A rl C C<P K 1�U� Company:Custom Air Systems, Inc.
City: 14tM I XLk- State:L._w Address:1615 SE Village Green Drive
Zip Code:qe�g-(.P -9/] Fax: City: Port Saint Lucie State:FL
Phone No. -9�1 " r? q Y - g q 5- I 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 F-Mail custairsys@aol.com
from the Owner listed above) State or County License CAC051810
if value of construction is$2SOO 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 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 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 U4 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-"
jr
, - ,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA _ STATE OF FLORIDA
il.t ,�., ,;�.
COUNTY OF ,` ����� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2 3 day of 110U-eAbtT 20, by this a3 day of AQVfelll 2R�by
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 Florida) (Signature of Notary Public-State of Florida
_ M
Yrt�'_°°L CHRISTINES H
CHRISnNES Commission No.? Jd.� � ►uyC0V- WM10N �cnission Na_ +7 I S� ��✓ ; MYCOMMIISSIONII
at r E)TIRES:Apr94 ZZI
°� `oe o EXPtRES.Apn74, 021 ��`r�oP�a taMedTluuBe9gn2 vices
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW RFVIFW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE I
COMPLETED
ev.2/7/19
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Custom Air Systems Inc. / c 15
1615 SE Village Green Drive • Port St.Lucie,FL 34952
(772)335-3232 • Fax(772)335-1968
Proposal and Agreement
Customer Name P0b* T4 Phone e' ��� Date*'a/aQ
Address 3 7-01 P�6'I co t114- Job Address
City, State, Zip L 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
1-C�l7�(U? Model Number(s) r
Make c�—
SEER EER AFUE Btuh Cooling `� Btuh Heating CFM
Installation shall include: V
1.D
�T
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
❑ 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 ❑ Com I Ae system start up
❑ Insulate refrigerant suction line(s) ❑ Provide for external combustion air ❑ t�I_year parts warranty
❑ Install refrigerant drier(s) ❑ New gas piping from to ❑ l 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 ❑ year service agreement (�
0 Meet all federal, state & local laws ❑ Condensation overflow safety switch 13 �J
Hurricane Fasteners for outdoor unit c>5 0
❑ Option (below) ❑ Total Investment $ � 5 O
t ,
Taxes $
Total Amount $ �
Down Payment $
Balance Due $
QTerms:
Acceptance (Custom Approyq (Company) `�w
By Date a0 By ✓,// Date 11 orl
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