HomeMy WebLinkAboutPermit App for 5004 Killarney Ave Apt B All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-6-21 Permit Number:
O
Building Pe'mit 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)462-1S78
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 5004 Killarney Ave Apt B
Property Tax ID#: 1301-615-0111-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
I
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout,-Qton/l./seerC57kw 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 _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sp. Ft. of First Floor:
Cost of Construction: $ 2,700 Utilities _Sewer _Septic Building Height:
i
OWNER/LESSEE: ONTRACTOR:
Name Green Trust Properties LLC Name: Shyan Wojtczak
Address: 312 Oak Harbour DR ompany: Cool Air Solutions of Florida, Inc.
City: Juno Beach, FL State:_ Address: 7901 Santana Ave
Zip Code: 33408 Fax: City: Fort Pierce State: FL
Phone No. 561-702-3568 ip Code: 34951 Fax: 772-801-5398
E-Mail: debra.mittleman@gmaiLcom Phone No 772-634-0491
Fill in fee simple Title Holder on next page(if different E-Mail coolairsol@gmaiLcom
from the Owner listed above) State or County License CAC# 1819009
If value of construction is 2500 or more,a RECORDED Notice of Coritmencement 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: T 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. l,fiyou intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice oT Commencement.
Z"k I v
Signatur Owner/L s Neefitractor as Agent for Owner Signature of ntractor/Li Ider
STATE COUNTOY OFORIDAFLORIDA
S+ Lucie COUNTY OF LUC'I(?
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of Q^ 2020 by this[ ay of Qom'(— 2020 by
LLLgJ0 L %L jGn (,c z1+cz-rL
Name of rson making st tement. Name of p.rson making st�ement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of identification
Pr duced Pr uced
&�JO_41 C�5mal 1CC.& -
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Commission No. �_ �I) Notary Public$Cate 0f Ff lrrtl ion N Y ot-r P.Usr� a of Florida
*0 r Amanda P Sander on r° Amanda P Sanderson
v MY commission CMG 11256 % My C,nnnssion GG 271256
of+� J aF xpa s
REVIEWS FRONT ZO 1 R PLANS VEGETATI
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.