HomeMy WebLinkAboutSyed, Najam, Permit St Lucie County, 07.08.2020All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
W.-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential vzz
PERMIT TYPE: A Q d f- ®
V ftc
PROPOSED IMPROVEMENT LOCATION:
Address: X l0`5 -'�)anckbu rc, L N
Property Tax ID 0 !7� - () 1 ® G - 000
Site Plan Name: d Ieon Aee_ Pi (w s
Project Name: ��} S y E D
DETAILED DESCRIPTION OF WORK:
��/Yl/1rl-e ��/S-F-iI]� e �U rin/riP,✓l � A' ,
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CONSTRUCTION INFORMATION:
Lot No. d
Block No.
Additional work to be performed under this permit -check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
0
Cost of Construction: $ 5, y EO 0xx Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE.
CONTRACTOR:
Name /Il-gm S yED
Name: S
M ES 1 LL /
Address: 06saabo L-Q- e__.
Company=_Qt�U1l�
1Z ,(1,J
�I
lT�� �r ea`�in� d
City:Z_fy� ` +, L, u CL f_� State: R
Zip Code: 3 QS � Fax:
Phone No. S (o I - Q3 Y - 7 3 8 (
Address: Qc-)S Nf_ Pr t iv 0. V t s-tnR(��l
City: `��,('± Si-, r' .06e State: eL-
Zip Code: 3 (-f qQ 33 Fax:
Phone No pt-(�rroC1-2d�jj
E-Mail_Q � tC t (qt r -(-(. C d M
State or County License CSC i8 l S 9'72
E-Mail:(wRk�(Qti-C-1, C.1)i(YA
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
is vdlur or consirucuon is ;pc3uu or more, a KMUK1Jt1J nonce or commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
N Vftrn EKED 703 Sand bSj to
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: ` Not Applicable
Name:
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 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
"!'DARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPR ENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON' JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR NDER ATTORNE BEFORE RECORDING YOUR NO)WE OF COMMENCEM T."
Signatu oZOne/re ee o ractor as Agent for Owner
Si e of Contra r enseHoST
E OF 1
T E OF FLORIDA
C NTYST. 1- OCke
UNTYOF _S �,, LUQ
he forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this $day of SU 120 -L by
this $ day of 7_0 ( 20c5L6 by
pia-tAO S
cz(w,5�
Name of person making statement.
Name of person making statement.
Personall,r ion
Personally Known OR Produced Identification
Type of I' R�n ` '%IA 1GGiNS
Type of Identification
Produce `� - {`.cats"y Public -State of Florida
=0 GG 956362
Produced
YMy Commission Expires
661rU5
February 09 2024
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- ate of Florida }
Commission No.GG M (o3(o,?, (Seal)
Commission No. (Seal)
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Rev. 1