HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/3/2021 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: 7809 WHITE IBIS LANE
Property Tax ID #: 3424-701-0061-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 4TON 14 SEER PACKAGE UNIT WITH 10 KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION.
Residential X
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
✓6echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4895
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: -
CONTRACTOR:
Name FRANCIS, ROSEMARIE MEYERS
Name: CURTIS SAMMONS
Address: 7809 WHITE IBIS LANE
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State: (—
Zip Code: 34952 Fax:
Phone No. 772-301-1669
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
11 Vdlur or uonsirucuon is zDuu or more, a KtWKutu 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 recording your 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 (e COUNTY OF 5 -r L to C t -G.=
Sworp to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization v "Physical Presence or Online Notarization
this day of tV,s2024 by , this _� day of ::� tt 112 202$ by
- CLLI L- c s , .- e y P � tS sij a tH c tt.S
Name of person making statement. Name of person making statement.
Personally Known Y OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub1f` State of Florida )
4: �p�V`;P& CHRISTINE B. ENGLIS
Commission No. q#61, QY,2 7 al)Commiasion # HH 0691
y '6 Expires April 4, 2015
Personally Known �/ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub ' - State of FlWj a) CHRISTINE B. ENGUI
Commission No.h(A69d1 l " al ssbni�HH0693
Eq*,sApra4,2025
0
?�Ofrtng� Baa.e Tin Budr--1 NYty Sw
REVIEWS FRONT ZONING SUPERVISOR PLANS i VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW j REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
I
Custom Air Systems Inc.
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772) 335-3232 • Fax( 772) 335-1968
Proposal and Agreement
Customer Name 4 ✓4 q\kell S
Address 7 M _9 21, s-
City, State, Zip
ou
b63 603
1500 —
Phone 77.�— �0 1 - Al g Date
Job Address -5q," -e-
Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
I Equipment Specifications
Maker ✓lModel Number(s) 06--/0
SEER _Iq EER AFUE Btuh CoolingBtuh Heating N �✓ CFM
X in boxes = Yes
❑ New Amp disconnect
emove existing equipment from premises
❑ New condensate drain system
❑ New Amp electric service
❑ Install energy saving setback thermostat
❑ New condensate pump
❑ New low voltage wiring
❑ New copper wire from to
❑ Install aux. condensate drain pan
❑ New weather resistant equipment stand
❑ Make air tight plenum transition
❑ New high efficiency air filter
El New reinforced equipment pad
❑ new supply diffuser(s)
❑ New humidification system
❑ New vibration isolation pads
❑ New duct run from to
❑ New return air filter grill
❑ New properly sized refrigerant lines
❑ Noise reducing flexible duct connector
[.�-M&et all code requirements
❑ New clean, dry ACR copper tubing
❑ Balance for uniform supply air distribution
;1, m to system start up
❑ Insulate refrigerant suction line(s)
❑ Provide for external combustion air
❑ 5 year parts warranty
❑ Install refrigerant drier(s)
❑ New gas piping from to
❑ �-year labor warranty
❑ Eva uate refrigerant system
❑ New vent pipe and cap
❑ S year compressor warranty
(�7� h rge to manufacturer's specs
l�an work area to customer's satisfaction
❑ year servic agreement
�i1i►
C'Meet all federal, state &local laws
C ondensation overflow safety switch
❑ /w.o�_sF9-* ' ' - II I �r���
2--'Hurricane Fasteners for outdoor unit
-,v04 d art$
G
❑ Option (below)
❑
Total Investment $ �L. 6
u
/X Taxes $
"GG�\ Total Amount $
Down Payment $1, 0 0 . G (J
��J' Vim' V� l� S I'1�Pal�✓/ �/ %� (J�� i���� , �(] Balance Due $ 3 Do
Terms:
Acce n ustomer)
By
Approval
Date By 4�
Dale