HomeMy WebLinkAboutpermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/27/2021 Permit Number:
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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: 8109 LONG DR
Residential X
Property Tax ID #: 3425-707-0171-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK.
LIKE FOR LIKE 4 TON 14 SEER PACKAGE UNIT 10 KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Addition work to be performed under this permit — check all that apply 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: $ 4500 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CHARLES & JILL KEITH
Name: CURTIS SAMMONS
Address: 8109 LONG DR
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State: FL,
Zip Code: 34952 Fax:
Phone No. 772-878-7715
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.
DESIGNE
Name:_
Address:
City: _
Zip:
_ Not Applicable
State:
Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Ziv. 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 Holder
1 STATE OF FLORIDA
STATE OF FLORIDA I
COUNTY OF ST t,V G6 8
COUNTY OF ;5 T l..:; C
Sw9rn to (or affirmed) and subscribed before me of
Swof n to (or affirmed) and subscribed before me of
Ph sicai Presence or Online Notarization
this day of i`r.%QJQ� 202� by
✓ Ph sical Presence or Online Notarization
this day of 2020 by
I
Cur►xwL,6►as
Name of person making statement.
Name of person making statement.
I Personally Known OR Produced Identification
Personally Known Yam' OR Produced Identification
Type of Identification
Type of Identification
i
Produced
Produced
��✓�G`L ci "r f
(Signature of Niftary Pu c- State of Florida)
CHMSTINE B.
Signature of Notary Pub �e State of FIB a )
CHWSTINE B. EWAJS
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Commission No. H v 6Q 7 Carrnris�io "H
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SUPERVISOR
PLANS VEGETATION
SEA TURTLE
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REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW I
DATE
RECEIVED
DATE
COMPLETED
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CUSTOM MR SYSTEMS INC. SALES * SERVICE * INSTALLATION * APPLIANCES
4615 SE, VILLAGE GREEN DR. PORT ST. LUCIE FL.34952
335-3232 465-0559 562-2777 FAX (772) 335-1968
CAC05181 0
CARRIER * RHEEM * GOODMAN * TRANE * AIR CONDITIONERS SS
KITCHENAID * WHIRLPOOL * APPLIANCES
Octobor 20, 2021 KI C) \,it (
NAME: CHARLES & JILL KEITH
PHONE: 772-878-7715
EMAIL! ji11kc--i.t'h1946@qzai1.,com
JOB NAME/ADDRESS: 8109 LONG DRIVE PSL, FL 34952
WE PROPOSE TO: REPLACE EXISTING AIR AND HEATING SYSTEM.
BID INCLUDES THE FOLLOWING.
1. 4 TON SYSTEM WITH 10 KW ELECTRIC STRIP HEAT. (SEE OPTIONS BELOW)
2. A/C SLAB IF NEEDED
3. CONNECT TO EXISTING HIGH AND LOW VOLTAGE WIRING. (BREAKERS AS NEEDED)
4, PERMIT (INSPECTION BY CITY REQUIRED)
5. CONNECT TO EXISTING DUCT SYSTEM
6. DIGITAL THERMOSTAT
7. TIE DOWN BRACKETS
S. ONE YEAR LABOR WARRANTY
9. FIVE YEAR ARCOAIRE PARTS WARRANTY.10 YEAR PARTS WHEN REGISTERED IN 30 DAYS OF
INSTALLATION FOR ORIGINAL OWNER.
ARCOAIRE 4 TON 14 SEER SYSTEM. PAJ448000KTPOA, 10 KW HEAT
FOR THE SUM OF: $ 4,735.00
IF PAID BY CHECK: $ 4,500.00 INITIAL
('$Q.wv creo. . --
QUOTE GOOD FOR 30 DAYS 3s l I . �o '11�
TO BE PAID: T II-M OF �El�VTCE
ACCEPTED�.�!Y'
SIGNED. ?el "141.
RONNIE LAUCH
CUSTOM AIR SYSTEMS INC.
Construction industnes recovery, fund; Payment may be available from the construction industries recovery fund if you lose money on a project Nt-fomied
under contract, where the loss results from specified violations of 11orida law by a state -licensed contractor, for information about the recover} fund and filing
a claim, contact the Florida construction industry licensing board.
11honc. 850487-1305 mailing addressDBPR customer ")ntact' 1940 N, Monroe St.. Tallahassee, Fl... 32399-0786