HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/12/2021 Permit Number:
Sa o L icC 'u -V%
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5167 N HIGHWAY A1A #1005
Property Tax ID #: 1411-709-0073-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 3 TON 14 SEER SYSTEM WITH 8 KW HEATER
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: $ 5195.00 Utilities: —Sewer _ Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name NANCY MARQUEZ
Name: CURTIS SAMMONS
Address: 5167 N HIGHWAY A1A # 1005
Company: CUSTOM AIR SYSTEMS INC
Address: 1615 SE VILLAGE GREEN DR
City: FORT PIERCE State: 1rC—
Zip Code: 34949 Fax:
Phone No. 772-559-7282
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 ZSUu 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:
City: State:
Zip: Phone
Zip: Phone:
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, 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.
Signature of Owner lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S-r L_U C t e
COUNTY OF S jr L r~
Sworjp to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this / �_ day of ` fN1aN 2024 by
Sworn to (or affirmed) and subscribed before me of
✓Physical Presence or _ Online Notarization
this � day of i�e�, /; 202$ by
J.
�
eLLe-L-cC 'S6mnwrt.s
eufztS 67,#iKntori5
Name of person making statement.
Name of person making statement.
Personally Known i/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of P46tary Pu ' - State of Florida)
1►Rr ru
�, ..,,. CFIRISTINE B. ENGLIS
Commission No. #f�(`J� Q,�� 7 # ai
� )Cortunission # HH 0693
�,� Expires April 4, 2025
w 9akWTMu
(Signature of Not ry Pub " - State of FWW a )
t CHRISTINE B. ENGLI
' # HH 0693
Commission No.,d�fyQ+FJ ��� a' al
Expires 4, 2025
�ofa�P M kdT?.BW3dN.Wy
7
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
J STOM AIR SYSTEMS INC. SALES * SERVICE * INSTALLATION
1615 SE. VILLAGE GREEN DR. PORT ST. LUCIE FL.34952
335-3232 465-0559 562-2777 FAX (772) 335-1968
CAC051810
CARRIER * RHEEM * GOODMAN * TRANE * AIR CONDITIONERS
May 11, 2021
NAME: NANCY MARQUEZ
ADDRESS: 5167 N AlA FT PIERCE, FL 34949
PHONE: * `bb!5
EMAIL: rJrla - 559 - ri a8 a,
JOB NAME/ADDRESS: 5167 ' N AlA FT PIERCE, FL 34949
HAS 3 TON SYSTEM. AIR HANDLER OVER WATER HEATER.
WE PROPOSE TO: REPLACE EXISTING HEAT AND AIR SYSTEM.
BID INCLUDES THE FOLLOWING.
1. 3 TON SYSTEM WITH 8 KW ELECTRIC STRIP HEAT (SEE OPTIONS BELOW)
2. REMOVE AND DISPOSE OF EXISTING EQUIPMENT
3. DIGITAL NON—PROGRAMABLE THERMOSTAT
4. CONNECT TO EXISTING REFRIGERANT AND DRAIN LINES
5. CONNECT TO EXISTING HIGH AND LOW VOLTAGE WIRING
6. CIRCUIT BREAKERS AS NEEDED
7. ONE YEAR LABOR WARRANTY -
8. FIVE YEAR TRANE/RUUD/CARRIER PARTS WARRANTY. 10 YEAR PARTS WARRANTY WHEN
REGISTERED FOR ORIGINAL OWNER, WITH IN 30 DAYS OF INSTALLATION.
9. PERMIT (SOMEONE WILL NEED TO BE AVAILABLE TO LET IN CITY INSPECTOR)
CARRIER 3 TON 14 SEER SYSTEM
24ACA436C003, FMA4P3600AL
FOR THE SUM OF: $ 4,945.00 INITIAL
CARRIER 3 TON 15 SEER SYSTEM
24ACA436C003, FMA4X3600AL
FOR THE SUM OF: $ 5,195.00 INITIAL
LESS 5% OFF ABOVE SYSTEM PRICES IF PAID WITH CHECK.
QUOTE GOOD FOR 30 DAYS
ACCEPTED ........................... SIGNED.........................
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