HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/1/2021 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 8215 CAPER LANE
Property Tax ID #: 3425-701-0142-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 3 TON 14 SEER PACKAGE UNIT 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 _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4480.00 Utilities: —Sewer _ Septic Building Height:
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Name ZILDA CARTER
Name: CURTIS SAMMONS
Address: 8215 CAPER LANE
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State:
Address: 1615 SE VILLAGE GREEN DR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 772-342-7221
Zip Code: 34952 Fax: 772-335-1968
E-Mail:
Phone No 772-335-3232
E-Mail CUSTAIRSYS@AOL.COM
Fill in fee simple Title Holder on next page (if different
State or County License CAC051810
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED 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: _ 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 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 commencing work or recording our Notice of Commencement
ev.
1
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Sf ,Z°c� c! >✓
STATE OF FLORIDA
COUNTY OF S� �u cI Q
Swof n to (or affirmed) and subscribed before me of
✓ Physical Pre ence or Online Notarization
this day of 202� by
Sworn to (or affirmed) and subscribed before me of
� Physical Presence of Online Notarization
this day ofsue— , 202t by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
Personally Known OR Produced Identification
Type of Identification,
Produced
(Signature of Notary�f blic- St of Florida)
(Signature of Notary Puf�Ffc- State; Florida )
CHRISTINE B ENGLIS
Commission No. � aI�tYCOMMISSION 8GG
ExPIRES:Apri14,2021
BOM @ e Note S
(/ P.CHRISTINE B
5�ommission No.»a,1�1'COMMISSION �GG
\o� ExrIRES:Hpr74,
s
0 Custom Air Systems Inc.
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(7 2) 5-3232 •Fax (772) 5-1968
Propos and Agreement S
Customer Name-
-�GZ"�" Phone % 2 -' .3q"�- I Date �D I
t "
Address cap Lr a Job Address
City, State, ZipL,[—,C;�— Work Phone(s)
11
We will furnish, install
and service the equipment listed below at the price, terms and conditions outlined on this proposal.
��V�'vCylC Equipment Specifications
Make odel Number(s)
SEER EER AFUE Btuh Cooling--L, -) 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
❑ New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
❑ Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ Evacuate refrigerant system
❑ Charge to manufacturer's specs
❑ ee Mall federal, state & local laws
Ga'Ot3ti( (below)
❑ 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
❑ New gas piping from to
❑ New vent pipe and cap
❑ Clean work area to customer's satisfaction
❑ Condensation overflow safety switch
❑ Hurricane Fasteners for outdoor unit
Da w�
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n ']Iuuncs —
❑ 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
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Total Investment $
Taxes
Total Amount
Down Payment "-G '`V
Balance Due
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