HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/28/2021 Permit Number:
4Q#
".7
Building 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: 12 LAKL VISTA TRAIL #205
Property Tax ID #: 3422-500-0166-000-1 Lot No._
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 2 TON SYSTEM 15 SEER WITH A 5 KW HEATER
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
t echanical _ 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. $ 4295.00 Utilities: _ Sewer _ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MARIE LEXIMA
Name: CURTIS SAMMONS
Address: 12 LAKE VISTA TRAIL APT 205
Company: CUSTOM AIR SYSTEMS INC
City: PORT ST LUCIE State: F4'�—
Zip Code: 34952 Fax:
Phone No. 561-292-8876
E-Mail:
Address: 1615 SE VILLAGE GREEN DR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
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
•• -�•�� �• •-...••aa•a•a.a•v• •� ��Vv VI IIWIC, d nr%.uf%ucu •Voiice or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
LAW INFORnnaT«1:
— Not Applicable
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 attorne efore commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Hol
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF - Is G. IJ G6 COUNTY OF 5 r L L; C : -2
S7rn to (or affirmed) and subscribed before me of j Swojn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization ✓ Physical Presence or Online Notarization
this Z R day of 2020 by this Z'J day of :c-) 2020 by
Cures SR Yll ■Y L'J 6<' fC � 6,J �•� .i� 3:L 'y' 4le.J
Name of person making statement. Name of person making statement.
Personally Known _Y_ OR Produced Identification
Type of Identification
Produced
(Signature of N tart' Pu c- State of Florida }
sJ'tY16si CHRISTINE B. ENG
Commission No. iiH � 6�.�d ? �u CwIrrissim#HH06
Expires April 4, 20
0
y�OF Fl��\ Bonded Tin mod meow:
Personally Known ` OR Produced identification
Type of identification
Produced
(Signature of Notary Pub State of F0 a )
' - CHRISTINE B. ENGU;
commission No.,. o-1,96 ",,C 7 * a60 i#NH0693
Expires Apd 4, 20n
dOM �•OF t\.� Bonded TNn &W0W PiobrrSm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
I
DATE —�
RECEIVED
DATE
COMPLETED
,�Y Custom Air Systems Inc.
C) 1615 SE Village Green Drive - Port St. Lucie, FL 34952
(772) 335-3232 - Fax ( 772) 335-1968
Proposal and Agreement
Customer Name 1 � e -o�yl nn e,
Address �'�L L�1f✓�yi C 4�
City, State, Zip _psi— r�t!
Phone ! C� 1�2 Y6
Job Address
Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
ki,L14 Equipment Specifications
Make WModel Numbers) r7'Q kil ) ��4 0
1�4_
SEER_EER AFUE Btuh Cooling Btuh Heating �&V CFM
X in boxes = Yes
❑ New Amp disconnect Remove 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 I; -*Me air tight plenum transition ❑ New high efficiency air filter
C New reinforced equipment pad ❑ new supply diffuser(s) ❑ New humidification s stem
❑ New vibration isolation pads
New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
Etnsu llate refrigerant suction line(s)
L—htvastall refrigerant drier(s)
cuate refrigerant system
mar to manufacturer's specs
eet all federal, state & local laws
El Option (below)
Terms
❑ 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
man work area to customer's satisfaction
;L-Eondensation overflow safety switch
U--Mrricane Fasteners for outdoor unit
Y
❑ NN return air filter grill
4 ' Meet all code requirements
.8-'Com 1 to system start up
13 year parts warranty
❑ year labor warranty
❑ year compressor warranty
❑ year wrvicip agreement
O
--
Total In estment $
Taxes $
Total Amount $
Down Payment $ I7 7 eU
Balance Due $ �—
Acceptance kCustomery^ Approval mpan
Date ;a/ X = y �20
j y B Date