HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/15/2021 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:
Address: 9985 GATSBY LANE
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: .
Cost of Construction: $ 4680
Name EARL GILLILAND
Address: 9985 GATSBY LANE
Sq. Ft. of First Floor:
Residential x
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
City: FORT PIERCE State:
Zip Code: 34945 Fax:
Phone No. 567-698-3678
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: CURTIS SAMMONS
Company: CUSTOM AIR SYSTEMS INC
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 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phor
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State
Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:_
Address:
City: —
Zip:
Phone:
State:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: PhonE
UWIVCK/ WN I KAL I UK AFFIUVI I 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 your Notice of Commencement.
Signature of Owner Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF S-r t. U C l e COUNTY OF i -'r L y<< z
Swo',p 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 I S day of 2024 by this _[� day of 14p r i l 2020 by
CLLr° L- L s QSA-*A „L, rt S rt p is ,5 i� iti of o
Name of person making statement. Name of person making statement_
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of JN6tary Publi'f State of Florida )
�/ jp�!;„!;* CHRISTINE B. ENGLIS
Commission No. i><f}66o
yVOCommission#HH0691
° Expires April 4, 2025
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub 'C11- State of FWD oa )
ipt.,...,. CHRISTINE B. ENGLI;
Commission No.##&fg,? 7 * alywmk-sIw#HH0M
13, ' E*ims April 4, 2025
'Fov ft°P Baadod T?n Bw10m Notary $m
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
N�94- — -
�-` I Custom Air Systems Inc.
1615 SE Village Green Drive - Port St. Lucie, FL 34952
o ( 2)335-3232 - Fa ( 772)335-1968 6, :6 6j
68P of Propsal and Agreeme
Customer Name, 7� j' I i I Phone S�6 Date
1
Address 5 Job Address
City, State, Zip f T I Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
Equipment
�S Specifications
Make G'�� Model Number(s) i A -t U(v 65 �a0C-Yr _
SEER EER AFUE Btuh Cooling Btuh Heating J A
ation shall
el
❑ New Amp electric service
❑ New low voltage wiring
❑ New weather resistant equipment stand
11 New reinforced equipment pad
❑ New vibration isolation pads
❑ New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
❑ Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ Evacuate refrigerant system
❑ Charge to manufacturer's specs
2OotMMei
t all federal, state & local laws
on (below)
,;,F�A4-6 jej �
'
Terms
ft]
❑ Install energy saving setback thermostat
❑ New copper wire from to
❑ Make air tight plenum transition
❑ new supply diffuser(s)
❑ New duct run from to
❑ Noise reducing flexible duct connector
❑ Balance for uniform supply air distribution.
❑ Provide for external combustion air
❑ New gas piping from to
❑ New vent pipe and cap
❑ Clean work area to customer's satisfaction
❑ Condensation overflow safety switch
❑ Hurricane Fasteners for outdoor unit
by C-A
CFM
' X in boxes = Yes
❑ New condensate drain system
❑ New condensate pump
❑ Install aux. condensate drain pan
❑ New high efficiency air filter
❑ New humidification system
❑ New return air filter grill
❑ Meet all code requirements
❑ Complete system start up
❑ U year parts warranty
❑ year labor warranty
❑ yearr
r compressor warranty
❑ � yjalhr%`C-�agreement
�
ad Taxes ess$
too, tO C)
Down Payment
Balance Due