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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/28/2021
Permit Number:
�7 �01 0V
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: 67 GOLF DR
Property Tax ID #: 3414-501-1701-000-9
Lot No.
Site Plan Name:
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 3.5 TON 14 SEER SYSTEM WITH 10 KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Addis' nal 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 Constructio �00
. Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE: --
CONTRACTOR:
Name: CURTIS SAMMONS
Name WILLIAM THIBODEAU
Address: 67 GOLF DR
Company: CUSTOM AIR SYSTEMS INC
City: PORT SAINT LUCIE State: �L
Address: 1615 SE VILLAGE GREEN DR
Zip Code: 34952 Fax:
City: PORT SAINT LUCIE State: FL
Phone No. 774-344-8441
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.