HomeMy WebLinkAboutpermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/7/2021 Permit Number:
V. LFLD1�
IL
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: 11 EL CAMINO REAL
Property Tax ID #: 3426-500-0246-000-8
Site Plan Name:
Project Name:
Residential X
LIKE FOR LIKE 3 TON 16 SEER HEAT PUMP SYSTEM WITH 5 KW BACKUP HEAT
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SANDRA A ERMARK
Name: CURTIS SAMMONS
Address: 11 EL CAMINO REAL
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State: r�'
Zip Code: 34952 Fax:
Phone No. 203-722-6466
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: - Phone:_
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
_ Not Applicable
State:
Not Applicable
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 recordine vour 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 �5-r LU C 12 COUNTY OF t; - L.` ;-e
Swork.. p to (or affirmed) and subscribed before me of
Physical Presence a, Online Notarization
this -),_ day of L& ,,,1 2024 by
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this day of 1i( 2024 by
0-c-1'-6 L s r<r nS i 0u riffs 511m in a n.S
Name of person making statement. I Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of P6tary Pu ' - State of Florida )
3.t►s`Y'° CHRISTINE B. ENGLIS
f} Commission No_ #fJ% QYo7 % Tal)C m sion # HH G693
°., A� Expires Apd 4. 2025
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub ' - State of :'.d) cHR15nNE B. ENGLI: �p
Commission No..:�01 ��� *al�#HHG693
I ' A,l Exphes W 4, 2025
�of /lD4 5-ded Tin 80--tNotgy San
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW i REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED f
7 �
Custom Air Systems Inc.
' 1615 SE Village Green Drive - Port St. Lucie, FL 34952
O _ n (772)335-3232 - Fax ( 772) 335-1968 Q
Proposal and Agreement
- 7� —G yle
Customer Name \ Phone �`� Date
9 /
Address �C �P-+� �� a1 e�� Job Address
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City, State, Zip � :S FL,_ 3yi S'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 -� () l &63G0Zl A` 'e-Zlc�Q%—/A"k W-
1 Model Numbers
SEER _ EER AFUE Btuh Cooling�r� Btuh
Heating_�CFM
JInstallation shall include:
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❑ New Amp disconnect ❑ Remove existing equipment from premises
❑ New Amp electric service ❑ Install energy saving setback thermostat
❑ New low voltage wiring ❑ New copper wire from to
❑ New weather resistant equipment stand 2 Make air tight plenum transition
New reinforced equipment pad ❑ new supply diffuser(s)
New vibration isolation pads ❑ New duct run from to
❑ New properly sized refrigerant lines ❑ Noise reducing flexible duct connector
El New clean, dry ACR copper tubing ❑ Balance for uniform supply air distribution
ulate refrigerant suction lines) ❑ Provide for external combustion air
�ll refrigerant drier(s) ❑ New gas piping from to
2-f'vacuate refrigerant system ❑ New vent pipe and cap
C-Clarge to manufacturer's specs -Clean work area to customer's satisfaction
❑�t all federal, state & local laws l�Condensation overflow safety switch
Z�-Vurricane Fasteners for outdoor unit
❑ Option (below) ❑
X in boxes = Yes
❑New condensate drain system
❑ New condensate pump
❑ Install aux. condensate drain pan
❑ New high efficiency air filter
❑ New humidification system
❑ N° return air filter grill
E�3M et all code requirements
2r Com ystemstart up
❑ year parts warranty
❑ ear labor warranty
❑ ear compressor warranty
❑ year sery ce a Bement
❑ W' ' r ►W/�'► t14S-v
(; .,
Total Invbstment $
! ! �-s
Taxes $
�V
Terms: icr, ..
fotaltAmOunt $
Balance Due $
11
Acc (Gusto rr er) Approval mpany)
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