HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/16/2022
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential
Address: 2105 OAK DR
Property Tax ID #: 143660200470001 Lot No.
Site Plan Name:
Project Name:
LIKE FOR LIKE 2.5 TON 14 SEER SYSTEM WITH 7 KW HEATER
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
xMechanical — Gas Tank _ Gas Piping — Shutters
_ Electric __.. Plumbing ,-_ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4840
Name TR INT TRUST FUND
Address: 3900 COMMONWEALTH BLVD
(Affidavit required)
Windows/Doors Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: — Sewer —Septic Building Height:
City: TALLAHASSEE State: FL
Zip Code: 32399 Fax:
Phone No. 772-519-0620 E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: CURTIS SAMMONS
Company: CUSTOM AIR SYSTEMS INC
Address: 1615 SE VIILAGE GREEN DR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax:
Phone No 772-335-3232
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.
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Name:
Address:
City: , State
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address._.._..____.
City:__
Zip: _ Phone: _
DRIVIATION:
MORI GAGE COMPANY: � � _ Not Applicable
Name:
Address:
City: _ State:
Zip: Phone:
_.__..........
BONDING COMPANY: _--Not Applicable
Narm!:
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 C unty makes no representatiarn that is ranting a permit will authorize the permit holder to build the subject structure
which conflicts with an�+ applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consutI with your Homeowner's 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: roorn additions,
accessary structures, swimming pools, fences , walls, signs, screen rooms and accessory uses to anothe?r non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
irmprovorrients to your property. A Notice of Commencement roust be recorded in the public records of St.
Lucie County and pasted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before comniencinR work or recording vour Notice of Commencement.
Signa�oC�ntra"or - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF 51L'
Sworn to for affirmed) and subscribed before me of
Physical Presence ar
Online Notarization
this day of _, 20
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Names of person making; statement.,
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s
( Personally Known CiR Producedidentification
Type of Identification oduced
(Signature of Notary Public- Stare of Fhrida)
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Commission Noe,ai r
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REVIEWS
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SUPERVISOR
PLANS � VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
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Custom Air Systems Inc.
1615 SE Village Green Drive • Port St. Lucie, FL 34952
(772) 335-3232 • Fax ( 772) 335-1968
Proposal and Agreement
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Customer Name,
o� ,D�, CJL ` c IoS 6a.k
Address
Phone 7 7.� — Date2 `f" 2 �
Job Address
City, State, Zip �Y" "ft I-e 1' �-4T ) • Work Phone(s)
We will furnish, install and service the equipment listed below at the price, terms and conditions outlined on this proposal.
Equipment Specifications
Make Model Number(s)
SEER EER AFUE Btuh C ' g Btu t ating CFM
Installation shall include: 30 -}Sc ?
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❑ New Amp disconnect
❑ New Amp electric service
❑ New low voltage wiring
❑ New weather resistant equipment stand
New reinforced equipment pad
New vibration isolation pads
E. New properly sized refrigerant lines
❑ New clean, dry ACR copper tubing
❑ Insulate refrigerant suction line(s)
❑ Install refrigerant drier(s)
❑ Evacuate refrigerant system
Charge to manufacturer's specs
Meet all federal, state & local laws
i
I gr Option (below)
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Terms:
Acceptance (Customer)
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
❑ 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
El
Approval
Date By
` X in boxes = Yes
❑ 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
❑
Total Investment $
Taxes $
Total Amount $
Down Payment
Balance Due
Da ,%'