HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Ooc)A
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Building Permit Application 8Z may
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 X
PERMITTYPE: New Construction
PROPOSED IMPROVEMENT LOCATION:
Address: MILY Q o o l f i G1 r
Property Tax ID k:
Site Plan Name: L
Project Name:
Lot No. % ^9ik
Block No. W .
I DETAILED DESCRIPTION OF WORK: I
Mod d -2)=
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
%Mechanical _Gas Tank _Gas Piping _Shutters' x'Win'dows/Doors
Electric KPllu�mbing _Sprinklers _Generator X Roof Pitch
Total Sq. Ft of Construction:9
2 I_ , Sq. Ft. of First Floor: 3000
Cost of Construction: $ �3 I Utilities: X Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Adams Homes of Northwest Florida, Inc.
Name: William Bryan Adams
Address: 3000'Gulf;Breeie. Parkway
Company: Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze . State: _
Zip Code: 32563 Fax:
Phone No.772-905-8394
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone No 772-905-8394
E-Mail: pslpermits@adamshomes.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail pslpermits@adamshomes.com
State or County License CRC1330146
1
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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SUPPLEMENTAL4CONSTRUCTIOA3LIEN>A1NINFORMATION
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DESIGNER/ENGINEER: _
Name: KeeaeeAssociates
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address MSouth Orange BlossomTra3
Address:
City: Apopka
Zip: 32703 Phone4e7-8802M
State: e-
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 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'r6trjctions 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 anothernori-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 LENDEWOR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_^
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
i
STATE OF FLORIDA
COUNTY OF Saimwde
COUNTY OF SatrM1lpde
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisudayof re10, .20; 0by
this _Lday of Feb .20cXOby
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
— '—
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(Signature of Notary Public -State of Florida)
(Signature of Notary Pu
PATRICIA ANN GRIFFIN
Commission No. Gc137624 )PATRICIA AN
E+frffW n No. GG137624 i': ••c MY CO�iRIION#GG737624
MY COMMISSION
G0137624-'?f'o,tti,,�.�' EXPIRES September26,2021
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