HomeMy WebLinkAboutWilliams, Michele - Permit Application 5172021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/17/2021 Permit N umber:
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V a @ LE o o to 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 FORA/C Chagne Out
�ROPgSED IMPROUEME'NT LOCATIONi
Residential x
Address: 805 Ulrich Road, Fort Pierce, FI 34982
Property Tax ID #: 3410-603-0070-000-0 Lot No. 4/5
Site Plan Name: ULRICH'SS/DBLK C E25 FT OF LOT 4 AND ALL LOT 5(0.25AC)(OR 1381-890; 2285-2269: 2620-420;3287-1413) Block No. C
Project Name: A/C Change Out
Like for like A/C change out. 3 ton 14 SEERvertical straight cool with 10kw heater.
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New Electrical Meter Second Electrical Meter
Additional 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 Construction: Sq. Ft. of First Floor: 1075
Cost of Construction: $ 3940 Utilities: —Sewer _Septic Building Height:
OWNER%LESSEE
CONTRACTORS
x.
Name Michele Williams
Name: Anthony Fenn
Address:1150 Southlakes Way SW
Company: A. S. Fenn LLC dba Assured Air Conditioning
City: Vero Beach State: _
Zip Code: 32966 Fax:
Phone No. (772)812-6886
Address: 278 NE Surfside Ave
City: Port St Lucie State: FI
Zip Code: 34983 Fax:
Phone No (772)202-2005
E-Mail: mlwilliams01 @comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail anthony.Fenn@assuredairconditioning.com
State or County License CAC1820274
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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DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x
Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x
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 lendar or an attornev before commencing work or recording vour Notice of Commencement.
Signat e o wn / Lessee/Contractor as Agent for Owner
` ' a u e o c or License Holder -
STATE OF FLORID 1
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STATE OF FLORI
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COUNTY OF
COUNTY OF
Sworq,tar(or affirmed) and subscribed
before me of
SworWor affirmed) and subscribed before me of
Notarization
/Ph sical Presence or
Online Notarization
/ Physical Presence or Online
this day of Ut /
2020 by
this 1?_ day of RAt� 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR
Produced Identification
Personally Known OR Produced Identificatiok_e
Type of Identificat'on
Type of Identifica p
Produced li
Produced
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(Signature of Notary Pub
(Signature of Notar ublic St
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u{puv np MARIA D. GOMEZ
0 \ Np ary Public - State of Florida
iZission
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No. /�i' J
tyv ore MARIA D. GOMEZ
i h \a,' yotarrypublic - State of Florid
Commission No
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202
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Bonded lhrough National Notary Ass
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