HomeMy WebLinkAboutPermit App for 605 Ulrich Rd Ronald FrenchAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-6-21
Permit Number:
ly LL 0 a°° p Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 605 Ulrich Rd Fort Pierce, FL 34982
Property Tax ID #: 3410-603-0086-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 ton package unit 14 seer 10 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 4290.00
Generator
Sq. Ft. of First Floor:
X
Iword ►n
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ronald French
Name: Shyan Wojtczak
Address: 605 Ulrich Rd
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34982 Fax:
Phone No. 772-370-9733
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
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 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 attorney before commencing work or recording our Notice of Commencement.
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Signatu of Owner/ lie see ontractor as Agent for Owner
Signature. f Contractor/ Ci e_rjse older
STATE OF FLORIDA ,
COUNTY OF 'Si �._0CtC
STATE OF FLORIDA�
COUNTY OF JI LC's
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
-'"- Physical Presence or Online Notarization
this (t;f-`day of d j'1C, ® 2020 by
iw —• Physical Presence or Online Notarization
this day of 0" r' t�_ 2020 by
Name of person making statement.
Name of -'person making' statement.
Personally Known OR Produced Identification
Personally Known i/ OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Pr aced
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arMy
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. C .7ti.)c>q_t— I) Notary Public State of
t4 r kmanda P Sander
tyy Commission GG
F'81 mi ion N� 4 _ Il rri ota 11 of Florida
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