HomeMy WebLinkAbout41750 PERMIT APP REVISED NOTARIZEDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/21/2021 Permit Number:
C)
Building Permit 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) 462-1578 C13DG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 341 ASHLEY ST
Property Tax ID #: 3403-802-0086-000-4 Lot No. 4
Site Plan Name: Block No. 7
Project Name: Job 41750
DETAILED DESCRIPTION OF WORK:
Mechanical AC change out - Goodman 2.5 TON - 14 SEER
cond#GSX 140301
a/h#ASPT35B 14
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 1,128 Sq. Ft. of First Floor:
Cost of Construction: $ 4,050 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Arvm 5 LLC
Name: Mark Steven Steiner
Address: 5001 Plaza on the LK Ste 200
Company: Fuss Free AC LLC
City: Austin State: TX
Address: 2880 SW 23rd Terrace Suite 101
City: Fort Lauderdale State: FL
Zip Code: 78746 Fax:
Phone No. (512) 531-6094 E-
Zip Code: 33312 Fax:
Mail: maintenancebids@rnsrenewal.co
Phone No 954-771-3333
Fill in%e simple Title Holder on next page (if different
E-Mail permit(Wussfreeac.com
State or County License CMC1250879
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is S7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 vour Notice of Commencement.
f rlaF'� �teVeYL �teineY
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Florida
Sworn to (or affirmed) and subscribed before me of Physical Presence or x Online Notarization
_
this 5 day of November 20 21 by
Merlyn Garcia
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
/ C/ & (/ L
Commission No.
,,'" MERLYN ESTHER GARCIA
IP''.
(Seal
Notary Public - State of Florida
d` Commission k Hill140488
My Comm. Expires Jun 10, 2025
Bonded through National Notary Assn,
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