HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/12/2021 Permit Number:
��Ir LULIE
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:
Adrlr,w 7658 BARN OWL DR
Property Tax ID #: 3424-800-0064-000-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 4 TON 14 SEER PACKAGE UNIT WITH 10 KW HEATER
Lot No._
Block No.
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: $ 4735.00 Utilities: —Sewer _ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: —
Name TERRY & JOHN COLLINS
Name: CURTIS SAMMONS
Address: 7658 BARN OWL DR
Company: CUSTOM AIR SYSTEMS INC
City: PORT ST LUCIE State: 1'
Zip Code: 34952 Fax:
Phone No. 518-885-6113
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.
DESIGN
_ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:_
Address:
City: —
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip:.
Phone:
— Not Applicable
State:
Not Applicable
UvvlmtK/ LUIV 1 KA(L 1 UK 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)pefore commencing work or recording 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 ST LVGt I COUNTY OF 5 -r L e
S7m to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this IAdav of _ CCJEL' t- 202m by
C u r 6 c S411 nn,5I
Name of person making statement.
Personally Known _ Y"'_ OR Produced Identification
Type of Identification
Produced
z
(Signature of N tary Pu c- State of Florida
tp _., P&S, CHRISTINE B. ENO
Commission No. fib 6Q� 7 # U CwRialm#HH06
EOK Apr# 4, 20
'Eos n.�' eaa�c nw auaa.�r�w:
Swojn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this —2-day of 2024 by
Name of person making statement.
Personally Known VOR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub�e State of Fl-jda )
CHRISTINE B. ENGUI
commission No.pyQ6 .F;U- 7 •�al�°"rdssi°"#HHON3
y 40 E*NftApr14,2D25
dan �of1.w aow.an.narao�eN.rnsn
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 0 Fax 772 335-1968
sue` emu/, �Q
Propagal and Agreement
Customer Name 5oA n LO l I �^ S Phone �� g� �" vDate I
Address 76-73 A090tfe� /
Job Address
City, State, Zip Pstl 1 2�1 ; / s� Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
n �, n Equipment Specifications
Make4 odel Number(s) / t/ � � 7 � 01
SEER EER AFUE Btuh Cooling Btuh Heating �v _ CFM
Installation shall include:
❑ New Amp disconnect
❑ New Amp electric service
❑ New low voltage wiring
❑ New weather resistant equipment stand
❑ New reinforced equipment pad
❑ New vibration isolation pads
❑ New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
❑ Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ Evacuate refrigerant system
O Charge to manufacturer's specs
❑ Mee 11 federal, state & local laws
COption (below)
ex
Terms
Accept.
By
❑ Remove existing equipment from premises
❑ Install energy saving setback thermostat
❑ New copper wire from to
❑ Make air tight plenum transition
❑ new supply diffuser(s)
❑ New duct run from to
O 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
❑ Clean work area to customer's satisfaction
❑ Condensation overflow safety switch
❑ Hurricane Fasteners for outdoor unit
X in boxes =
❑ 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
O
❑ Total Investment $
r�)a (jov-)rl
I�
�f 71
Taxes $
Total Amount
Down Payment $
Balance Due
Yes