HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a�'dd Permit Number: a ado "O�i
`- U �' 3 RECEIVED
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Building Permit Application FEB 14171)
Planning and Development Services ST. Lucle County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce. FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: New Construction -5 �
PROP®SEDIMPR`_OV�ENIENTL_OCATION� i< ;F3`r k, s.
,..£A,!,' COW �:�,x}Y�0.h r�!v..A.-...r:
Address: 512> 55 TQr)gc to Dr,
Property Tax IDa: 3H02 — 010 7 0I"T9 — OOO -1 Lot No. 3c
Site Plan Name: AG1am S fforn CS Block No. 7&
Project Name: AdQM S Horne S- OF 600-hlue t Ftorfdet INC.
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�CONSTRUCTIONYINF®4RMATION tom? `. _ f h F =f :'x'. ' ;.'tza :- ;M , ..
Additional work to be performed under this permit —check all that apply:
XMechanical _GasTank� _Gas Piping _Shutters Windows/Doors
X X
Electric %%Plumbing _ Sprinklers _ Generator - 'Roof Pitch
Total Sq. Ft of Construction: 515 Sq. Ft. of First Floor: ) 9 19
Cost of Construction: $ Utilities: X Sewer —Septic Building Height:
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Name: William Bryan Adams
Name Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
Company: Adams Homes of Northwest Florida, Inc,
City: Gulf Breeze State: _
Address:3000 Gulf Breeze Parkway
Zip Code: 32563 Fax:
City: Gulf Breeze State: FL
Phone No.772-905-8394
Zip Code: 32563 Fax: 772-905-8511
E-Mail: pslpermits@adamshomes.com
Phone No772-905-8394
Fill in fee simple Title Holder on next page ( if different
E-Mail pslpermits@adamshomes.com
State or County License CRC1330146
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: KeeseeAs dates
Name:
Address: 945 Seem orange 9lossm Trail
Address:
City: Apopka State: FL
City:
State:
Zip:32703 Phone407-ND-2333
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 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."
igna urn of Owner /Contractor as Agent for Owner
Signature of Contractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF samlLude
COUNTY OF s.i.1 Ude
The fo1r� oing instrument was acknowledged before me
F-EAD
The for oing instrument was acknowledged before me
this t�� day of 20 iL0 by
this day of F.Q t!� 20 IA>by
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(SigR7Ture of Notary Public-
V."QpMATRICIA ANN GRIF
FJFj
nature of Notary Public- State of Florida
Commission No. GGiar62a
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mission No. ccisTsz4 a`•s�`•a P'��IA ANN GRIF
'= My COMi41
ISSION # GG137
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DATE
RECEIVED
DATE
COMPLETED
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