HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/1/2021 Permit Number:
�� ��� `� ����� 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: 102 AQUA RA DR
- Residential X
Property Tax ID #: 4511-811-0022-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
RELOCATE AIR HANDLER FROM ATTIC INTO A CONDITIONED SPACE INTO FRONT BEDROOM CLOSET.
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: $ 2150.00 Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name HENRY NIELANDER
Name: CURTIS SAMMONS
Address: 102 AQUA RA DR
Company: CUSTOM AIR SYSTEMS INC
City: JENSEN BEACH State: i �_
Zip Code: 34957 Fax:
Phone No. 772-834-2177
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
it value or construction is Lsuu or more, a KLLUKutD 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 recordiniz vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
ot, � -"!;; I �'t _ - - - -
Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF �� f '(66 ct COUNTY OF X�
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
✓' Physical Presence or Online Notarization Physical Presence or Online Notarization
this //� day of 0,,Q-i \ 2029 by this _j_ day of �� i \ 2024 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- Stake of Florida )
VI li So2 S ot� P01,, CHRISTINE B ENGLISt
Commission No. * eI)MYCOMMISSION #GG06
m EXPIRES: April 4, 2021
00ntl ® el N Se
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Notary P#fc- Stat f Florida )
CHRISTINE B ENM
Commission No. W)MYCOMMISSION#GGi
1-6 `ag- EXPIRES: AprA 4, 20
as 0 WNW TMu
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Nev. oInILu
PERMIT #
CQU NTY
t L O R I D A
thy:
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB-CONTI ACTOR AGREEMENT
Wonipw Name!( ividual Name) --- --
'Mug I Sub -contractor for
(T�Tc of Trade)
For the project Incased at 10a RC t(--O- Q-R ZfL.. -
hm!c agreed to be
( rimary Ccmtractor) -
(Project Street Address or -Property Tax )n #)
Cikpw h FL 649'S1
It is understood that, if there is any change of status regarding our participation with the above mentioned
Project, the Building and Code Regulation Division of St. Lucie County wbe a wised pursuant to the
riling of a Change of Sub -contractor notice. /
CUh f< SIGN TUILE(QuuliF.f, -..--
�U-
ems,, SL'B C'UNTR�CrUR SIGNATURE ((2uwgtiery --
PRtN,r NAMF. -
COUNTY CEItTtFICAT)ON NUM�it
State of Florida, County of
The tor"Ming inetMtnent was signed before ate this I day of
who is porwrnally known -" or has produced a MM
as identification.
til„II4l Ur.' ut \nr � {fubi' r'—"'
Print Name of tiourr Public
CHRISTINE B ENGUSH
+ Mr COMMISSION 0 GG 052546
94.0� EXPIRES: Apri 4, 2021
Fcr Boa 5-,", T,- -ig- Nerary
1f
COUNTY CERTiFIC.ATIO?VA'NUlyBig
State of Florida, C'ouoty of ST ()(�i e
fhe foregoing instrament was a1XWd before me this day of
2Q1. by
who is personaily known _Zur has produced a
aside canon.
ST.ANrr
signature of Notary Public 41':1 NP
Priat !Named Notary
:? tt •. ALISON HANSON
MY COMMISSION # GG 970043
EXPIRES: March 16.2024
Bonded Thru Notary public UndenrHtero
CUSTOM AIR SYSTEMS INC. SALES * SERVICE * INSTALLATION
1615 SE. VILLAGE GREEN DR. PORT ST. LUCIE FL.34952
772-335-3232 772-571-1080 FAX (772) 335-1968
CAC051810
LENNOX * CARRIER * RUUD * GOODMAN * TRANE * AIR CONDITIONERS
April 1, 2021
NAME: TED NIELANDER
ADDRESS: 102 AQUA RA DRIVE JENSEN BEACH, FL 34957
PHONE: 772-834-2177
EMAIL: candlekristen@aol.com
WE PROPOSE TO: UNINSTALL AIR HANDLER FROM ATTIC AND INSTALL IN FRONT BEDROOM CLOSET
ON STAND AND CONNECT NEW PLENUMS TO EXISTING DUCTWORK AND INSTALL NEW CONDENSER SLAB
PER CODE.
BID INCLUDES THE FOLLOWING.
1. NEW SUPPLY & RETURN PLENUM
2. REPLACE REFRIGERANT LINES
3. CONNECT TO EXISTING HIGH AND LOW VOLTAGE WIRING. (BREAKERS AS NEEDED)
4. AIR HANDER BOX AND STAND AND CONDENSER SLAB
5. PERMIT (INSPECTION BY BUILDING DEPARTMENT REQUIRED)
6. CONNECT TO EXISTING DUCT SYSTEM
7. NEW DRAIN LINE AND SAFETY FLOAT SWITCH
8. CONDENSER TIE DOWN BRACKETS
9. ONE YEAR LABOR WARRANTY
10. FIVE YEAR PARTS WARRANTY.
FOR THE SUM OF: $ 2,150.00 (PLUS TAX)
QUOTE GOOD FOR 30 DAYS
TO BE PAID: AT TIME OF SERVICE.
ACCEPTED ..........................
INITIAL
S I GNED . .... . .
RONNIE LAUCH
CUSTOM AIR SYSTEMS INC.
Construction industries recovery fund: Payment may be available from the construction industries recovery fund if you lose money on a project performed
under contract, where the loss results from specified violations of Florida law by a state -licensed contractor. for information about the recovery fund and filing
a claim, contact the Florida construction industry licensing board.
Phone: 850487-1395 mailing address: DBPR customer contact, 1940 N. Monroe St., Tallahassee, FL. 32399-0786