HomeMy WebLinkAboutpermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/4/2021 Permit Number:
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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: 8231 MULLIGAN CIR
Property Tax ID #: 33727-502-0150-000-0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION CAE WORK '
INSTALL 2 TON 14 SEER SYSTEM WITH 5 KW HEATER
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 _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 4367.00 _ Utilities: _ Sewer _ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROBERT & FLORENCE FIELD
Name: CURTIS SAMMONS
Address: PO BOX 643
Company: CUSTOM AIR SYSTEMS INC
City: NEW YORK State: _
Zip Code: 10034 Fax:
Phone No. 772-873-0515
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
,,,uuce of t-ommencemem is requireo.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
�o 1E ., LAW INFORMATOid: _
Not Applicable MORTGAGE COMPANY: _ Not Applicable
State
_ Not Applicable
Name:
Address:
City:
Zip: Phone:
State:
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 attornny efore 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 _ S7 L U GCE COUNTY OF 5 -' L
swgrn to (or affirmed) and subscribed before me of Swojn to (or affirmed) and subscribed before me of
7D✓ Physical Presence or Online Notarization ✓ Physical Presence or Online Notarization
this `f day of 2024 by this tE day of h,�g���_. 2020 by
Cur6S JAa = K S i �
Name of person making statement. Name of person making statement.
Personally Known V"'_ OR Produced Identification
Type of Identification
Produced
(Signature of Notary PuY(c- State of Florida )
CHRISTINE S. EKG
Commission No. W v 6TGa � 7 * u Cwwi&Ww#HH0(
Expires April 4, A
."tOF F%.6'F BOW01 TM BudW NMYy,
Personally Known V OR Produced Identification
Type of Identification
Produced
,r
(Signature of Notary Pub ' - State of FWrida )
iFl apt,....`,.), CHRISTINE B. ENGU:
itmmission No.,/ W422J6 fb� 7 alywa "SHH06W
Expires Apd 4, 2M
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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 Phone
Address
City, State, Zip
Job Address
Work Phone(s)
Date
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
Make
Model Number(s)
Equipment Specifications
SEER EER AFUE Btuh Cooling Btuh Heating CFM
Installation shall include:
❑ 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
❑ 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
❑ New clean, dry ACR copper tubing
❑ Balance for uniform supply air distribution
❑ Insulate refrigerant suction line(s)
❑ Provide for external combustion air
❑ Install refrigerant drier(s)
❑ New gas piping from to
❑ Evacuate refrigerant system
❑ New vent pipe and cap
0 ❑ Charge to manufacturer's specs
❑ Clean work area to customer's satisfaction
❑ Meet all federal, state & local laws
❑ Condensation overflow safety switch
❑ Hurricane Fasteners for outdoor unit
❑ Option (below)
❑
M Terms:
u
Acceptance (Customer) Approval (Company)
By Date By
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
❑ year parts warranty
❑ year labor warranty
❑ year compressor warranty
❑ year service agreement
El
Total Investment $
Taxes
Total Amount $
Down Payment $
Balance Due
Date