HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/8/2021 Permit Number:
Building pp 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:
PROPOSED IMPROVEMENT LOCATION:
Address: 5767 DEER RUN DR
Property Tax ID #: 1407-601-0002-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 2.5 TON 14 SEER SYSTEM WITH 5KW HEAT
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
JMechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 4040.00
_ Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name OLIVIA BETTENCOURT , MARIA ROCHA
Name: CURTIS SAMMONS
Address: 5213 DEER RUN DR
Company: CUSTOM AIR SYSTEMS INC
City. FORT PIERCE State: _�V
Zip Code: 34951 Fax:
Phone No. 772-643-7992
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
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.
i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
I
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, 1 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 anffattornet before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 5 'T L v C t -�-
Swore to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or. Online Notarization ✓Physical Pres nce or Online Notarization
this � day of _ c► \ , 2020 by this X day of 202� by
y C'
tee^ 'fL c S � t4• nt ►�.Q n S J � it t L tS !1 JM pt drtL
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 Lary Pu - State of Florida) (Signature of Notary Pub ' -State of Flbfla) CHRISTINE B. ENGLI
�►�`Y' CHRISTINE B. ENGLIS � ••"••.
� ,T f�D6 �3.� % * al� # H , 2025 1
Commission No. %�f�b6 Q3,Z7 * aliCommission#HHO&93 Commission No.:. ,5� ExpiresApni4,2025
°a Expires April 4. 2025
OQ� BondM TMu Of IL Sw&d Th. S.Jiid Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
i
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Custom Air Systems Inc.
12198 County Rd. 512 • Fellsmere, FL 32948
(772) 571-1080 • Fax ( 772) 571-9878
Proposal and Agreement
Customer Name_ 11A4L,C—� Ae 0 C, ; Phone (0(4 Date
-
Address
t,.' � .
Address � s-�-� .� �,;-i;,n. tom. � Job Address
� �l z�
City, State, Zip- j *fl Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
g Equipment Specifications
Make l i,j'''i.-' ..- Model Number(s) 1 C e�te�J sCra
SEER EER AFUE Btuh CooIin '<- CFM
g ��... 'Btuh Heating �--
❑✓Newer Amp disconnect
New Amp electric service
New low voltage wiring
New weather resistant equipment stand
C New reinforced equipment pad
❑ New vibration isolation pads
❑ New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
❑ insulate refrigerant suction lines)
-4A stall refrigerant drier(s)
C'Fvacuate refrigerant system
4 lsiitarge to manufacturer's specs
❑ Meet all federal, state & local laws
❑ Option (below)
{`Remove existing equip ent from premises
Install energy savi � -. 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
�5\�qAp of
C,
Terms:L
Xinbxes = Yes
❑ 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
Total Investment $_
Taxes
Total Amount $
Down Payment $
Balance Due $
Acceptance (Customer) Approval ( o any)
By Date By Date