HomeMy WebLinkAboutPERMIT APP - 6-5-20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/5/20
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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 TYPE:GAS
rrturuatu IMNKUVEMENT LOCATION:
Address: 1554 NW SWEETBAY CIR
Property Tax ID #: 4426-803-0039-000-7
Site Plan Name: HARRIS
Project Name: HARRIS
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES
CONSTRUCTION INFORMATION:
Permit Number:
Building Permit Application
Commercial Residential X
Additional work to be performed under this permit —check all that apply:
_Mechanical XGas Tank as Piping _ Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 2300
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Lot No.
Block No.
Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameAndrew S Harris
Name: Cheyenne Ellison
Address:1554 NW Sweet Bay CIR
Company: Elite Gas Contractors
P Y�
City: Palm City, State: _
Zip Code: 34990 Fax:(772)220-1829
Phone No.(772)220-9678
Address:2130 Poma Drive
Palm City Y State: FL
Zip Code: 34990 Fax:(772)220-1829
Phone No (772)220-9678
E-Mail: emcintosh@elitegasco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of constructinn Ic Sxnn...e ncrnnncn .�_.:___ -
E-Mail emcintosh@elitegasco.com
State or County License 18361
- -- --- u... umurnenc is regwrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of 0 r/ Lessee/Contractor as Agent for Owner
Signature of Contr r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MUy-+i 1n.
COUNTY OF M ca. -Ili vl,
The forgoing instrument was acknowledged before me
The forgoing instrurent was acknowledged before me
this .9� dayof Jtir4 .20&0by
this-SL-dayof t]ulne .20a01by
CAN yam.
C4-
Name cf son mak n/g/statement.
Name of p on makingstatement.
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Personally Known `� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(SignaturedfNoar1Pc-St�dtO'Bf'V4®FR�p Floritla
(Slgnatureof otary
Desiree N McIntosh
My commission GG 283399
003016% Notary Pub[[1,,S�ta�lI of Florida
Commission No. i es 12mri(�l)
Commission No. Desiree NIW WIsh
'
y commission GG 283399
Expires
aw� 12/11/2022
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Rev. 2///19