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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 10/18/2021 Permit Number: t 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: 1823 WALDEN PONDS DR Property Tax ID#: 2303-211-0025-000-5 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: LIEK FOR LIKE 3 TON 14 SEER PACKAGE UNIT 10 KW HEATER New Electrical Meter Second Electrical Meter ------------- CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: y...POlechanical _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: $ 4184.00 Utilities: —Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: Name CHARLES SHELHAN Name:CURTIS SAMMONS Address: 1823 WALDEN PONDS DR Company:CUSTOM AIR SYSTEMS INC City: FORT PIERCE State:�� Address: 1615 SE VILLAGE GREEN DR Zip Code: 34945 Fax: City: PORT SAINT LUCIE State: FL Phone No.419-367-8313 Zip Code: 34952 Fax: 772-335-1968 E-Mail: Phone No 772-335-3232 Fill in fee simple Title Holder on next page ( if different E-Mail CUSTAIRSYS@AOL.COM from the Owner listed above) 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. v-- s DESIGNERJENGINEER: ____Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: , Address: ; Address: City: State: ICity: State: Zip: Phone i ZiP: Phone: i FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY: Not Applicable 1 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 Horne 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 efore commencing work or recording our Notice of Commencement. Signature of Owner/Leissee/Contractor as Agent for Owner Signature of Contractor/License Holder l STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S 1 t,V G6 COUNTY OF Swprn to(or affirmed)and subscribed before me of Swof n to(or affirmed)and subscribed before me of I/ P +ysical Presence or Online Notarization ✓ Physical Presence or Online Notarization i this �'J day of_ ��,2024 by th_lsle day of QC ,017P(�202� by C UJ r 6 S q Ian wLe VL Name of person making statement. Name of person making statement. 4 Personally Known V^OR Produced Identification Personally Known V' OR Produced Identification Type of Identification Type of Identification Produced i Produced A4� (Signature of Niftary Pu c-State of Florida ) Signature of Notary Pub' -State of Fl-j�la ) 'VAY rue CNR MNE B.E ip<<...,, CMSTINE B. Q ip,,...,�c�, #HN Commission No.�H0 6fjU .�� C.omrr�ission#NN mmission No.dblb6l� ,?_7 �alo � o�A` aonM9ud +NeWr '�ora�o 9a.e�eTtwwa�twirr as REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I RECEIVED DATE COMPLETED Rev. 5/6/20 ��c—oc—�r�G—�oo�=�o� �G Custom Air Systems Inc. O 1615 SE Village Green Drive • Port St.Lucie,FL 34952 (772r 5-3232 • Fax(772 335-1968 0 Pro osaVand Agreement P 0 Customer Name C e s S Aee F `eAn Phone 1 /—� Date Address A4 Q{*7 n©"" �5 . Job Address City, State, Zip 7 1 FI t 3V 9r Work Phone(s) We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal. O Equipment Specifications Make Model Number(s) T-0 N SEER EER AFUE Btuh Cooling Btuh Heating �� CFM Installation shall include: G,A r � n c � � 0 0 � X in boxes = Yes ❑ New Amp disconnect ❑ Remove existi equipment from premises ElNew condensate drain system ❑ New Amp electric service El Install energy aving setback thermostat [I 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 ❑ 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 ❑ Meet all code requirements ❑ New clean, dry ACR copper tubing ❑ Balance for uniform supply air distribution ❑ Complete system start up ❑ Insulate refrigerant suction lines) ❑ Provide for external combustion air _L0 year parts warranty ❑ Install refrigerant drier(s) ❑ New gas piping from to I year labor warranty ❑ Evacuate refrigerant system ❑ New vent pipe and cap _In year compressor warranty ❑ Charge to manufacturer's specs ❑ Clean work area to customer's satisfaction ❑ year service agreement ❑ Mee all federal, state & local laws El Condensation overflow safety switch ❑ ❑ Hurricane Fasteners for outdoor unit l9 Option (below) ❑ Total Investment $ Taxes $ Total Amount $ Down Payment $ Balance Due $ Terms: Acceptance (Customer) Approval an ` By Date By Dat� �oc—coo©c�000000�c—ooc=�0000��c000cooac�c—��