HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/14/2021 Permit Number:
13
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7614 GREENBRIER CIR
Residential X
Property Tax ID #: 3322-700-0072-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 5 TON 15 SEER SYSTEM WITH 10 KW HEAT
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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
Total Sq. Ft of Construction:
Cost of Construction: $ 6165
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Building Height:
Pond
Pitch
OWNERAESSEE:
CONTRACTOR:
Name ETHER BERKOFF & RENE & JOHN LIPSIO
Name: CURTIS SAMMONS
Address: 7614 GREENBRIER CIR
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State: 1�L
Zip Code: 34986 Fax:
Phone No. 772-448-8132
Address: 1615 SE VILLAGE GREEN DR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail CUSTAIRSYS@AOL.COM
State or County License CAC051810
VO UV uwiibuucuun is couu or more, a KtLUKutu Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencin2 work or recording our Notice of Commencement
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF �°u
STATE OF FLORIDA
'P C/
COUNTY OF
Swofn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
V` Physical Presence or Online Notarization
Physical Presence or Online Notarization
this �— day of j noc c- _ 2020 by
this I`L day of _ , , ;� . 2024 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
'-fI�
(Signature of Notary F06blic- St of Florida)
(Signature of Notary Public- Stat iof Florida )
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�{ ca ,` ottRY Pue�� CHRISTINE 8 ENGLIS
Commission No. tl�Vl J `t ? a1)1YC�OMMISSION#GG055
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ommissionNo. GA d.�J s'tb ♦, 4J)MYCOMMISSION#GGt
EXPIRES: April 4, 2021
N !\o� EXPIRES: A R 4, 2%
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
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 C � Z ( 13 eC 40 -M— Phone ti K 2 — Y I 3.0 DateI
Address 7 <nr b r, Pr c.2te Job Address
City, State, Zip ESL , I A q K (P 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 R 1) OD Model Number(s) R RtT G-DOI t n M (0(0(0
SEER c 5 EER AFUE Btuh Cooling R d Btuh Heating 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
❑ 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
Complete system start up
❑ Insulate refrigerant suction line(s)
❑ Provide for external combustion air
C� �O 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
❑ year service agreement
Meet all federal, state & local laws
Condensation overflow safety switch
Hurricane Fasteners for outdoor unit
❑
❑ Option (below)
' ❑
Total Investment $ f.
6 Y
Taxes $
Total Amount $
(� r►.i °
G r3-j It <YY C� OCA
Down Payment $
a
CC
J Balance Due $ j 1� s
Appro 1 (Company)
-15a'telbl Id, i By Date
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