HomeMy WebLinkAboutBuilding permit appATM
YMORTGAGE
DESIGNER/ENGINEER:
Name:
^ Not Applicable
COMPANY: _ Not Applyicable
Name:
Address:
Address:
City:
State:
j City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
, Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
I Name:
Address:
City:
Zip: Phone:
( 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 they first inspection. If you intend to obtain financing, consult
with lender or an attornevbefore cornmencinp work nr rPrordino vni it NntirP of CnmmPnramPnt
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF .37 LV Gi, g
COUNTY OF 5 -r L. t.: e : -
Sw9rn to (or affirmed) and subscribed before me of
✓ Physical Presence
SwoJn to (or affirmed) and subscribed before me of
or Online Notarization
this l day of 02ip by
✓ Physical Presence or Online Notarization
this I day of 2020 by
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I
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Name of person making statement.
I Name of person making statement.
Personally Known Y_ OR Produced Identification
Personally Known V / OR Produced Identification
Type of Identification
Type of Identification
Produced
I Produced
(Signature of N tary Pu c- State of Florida)
y Poe, CHRISTINE S. E
Signature of Notary Pub 'e State of FI �a� )
CHRISTME
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Commission No. /7iy D 6T�a 7 * w CommissionM
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
-r -1W/—
CU ON AIR SYSTEMS INC. SALES * SERVICE * INSTALLATION
1615 SE. VILLAGE GREEN DR. PORT ST. LUCIE FL.34952
335-3232 465-0559 562-2777 FAX (772) 335-1968
CAC051810
LENNOX * CARRIER * RUUD * GOODMAN * TRANE * ARCOAIRE * CHAMPION * AIR CONDITIONERS
January, 30, 2019
NAME: RONALD WHITFORD
PHONE: 772-343-8328
C, ;1 r�andec/,'t-;Z&o).com
JOB NAME/ADDRESS: 8216 13T" HOLE PT ST LUCIE, FL 34952
WE PROPOSE TO: INSTALL DUCTLESS MINI SPLIT SYSTEM ON PORCH.
BID INCLUDES THE FOLLOWING.
1. MITSUBISHI HEAT PUMP MINI SPLIT 12,000 BTUS 17 SEER
2. INSTALL REFRIGERANT AND DRAIN LINES
3. CONTROL WIRE FROM INDOOR TO OUTDOOR UNIT
4. REMOTE THERMOSTAT
5. SLAB
6. AIR CONDITIONING PERMIT (INSPECTION BY BUILDING DEPARTMENT REQUIRED)
7. RUN AND TEST SYSTEM
B. ONE YEAR LABOR WARRANTY
9. 10 YEAR PARTS WARRANTY (10 YEAR WARRANTY APPLIES TO ORIGINAL OWNER AND IF SYSTEM
IS REGISTERED WITH MITSUBISHI WITHIN 30 DAYS OF INSTALL)
MITSUBISHI HEAT PUMP SYSTEM MUZ—JPI2WA—U1, MSZ—JPI2WA—Ul
FOR THE SUM OF: $ 2,995.00
IF PAID WITH CHECK: $ 2,845.00
INITIAL
10 YEAR LABOR AGREEMENT ON MITSUBISHI ADDITIONAL $ 670.00 PLUS TAX
FOR THE SUM OF: $ 716.70 INITIAL
QUOTE GOOD FOR 30 DAYS
TO BE PAID: AT TIME OF SERVICE.
ACCEPTED ........................... SIGNED.... �.
ONNIE LAU
CUSTOM AIR SYSTEMS INC.
Construction industries recovery fund: Payment may be available from the construction industries recovery fund if you lose money on a project performed
under contract, where the loss results from specified violations of Florida law by a state -licensed contractor. for information about the recovery fund and filing
a claim, contact the Florida construction industry licensing board.
Phone: 850-487-1395 mailing address: DBPR customer contact, 1940 N. Monroe St., Tallahassee, FL. 32399-0786