HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE'CQQMPLETED FOR APPLICATION TO BE ACCEPTED
Date: — Permit Number:
+ RECEIVED
«// FEB.,O 3.2020
Building Permit Application PermInInBDe
Planning and Development Services 9E ting CCU,,,
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
PROPO,SEDIMPRQnUE'IVIENTLOC%�zT�O�V�
Address: -15313 Oirch
G�fJr.
Property Tax ID N:: /640- 60'3 " d 39 4 " 000 — r] Lot No. 4(0
Site Plan Name: Hdorn,s Homes Block No.
Project Name: _Adom,S PnrneS OF Nor+hweSt Floridg, /NG.
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ONE®FWORK<"� `" ' , f," ,'a ,� �,zj
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�) C3eclroOf''S 12 an-fh I �2- car garage
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Additional work to be performed under this permit —check all that apply:
)(Mechanical _Gas Tank _Gas Piping _Shutters x Windows/Doors
X Electric NPlumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 4 ga,. Sq. Ft. of First Floor:
Cost of Construction: $ ;Z.(4P2, 900 Utilities: X Sewer —Septic Building Height:
Name Adams Homes of Northwest Florida, Inc.
Nye; William Bryan Adams
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 No77.2-905-8394
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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SUPPLEMEN AL,CONSTRUCT�ION�LIEN LAI7V�INFORMAT�ON="'
T.a •>.rmF-gsxnt.�w�:° 9, w;e .,
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: keeseeAssociates
Name:
Address: B 5South orangeBlossom Trail
Address:
City: Apopka State: FL
City: State:
Zip: 32703; Phone407-880-2333
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
BONDING COMPANY: XNot 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 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 thaf 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, fence's, 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."
Sgnatureof Owner JContractor as Agent for Owner
Signature of Contractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucia
COUNTY OF- Saint Lurie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of lao.t/OX Q 202�by
this day of,�JOWN 2020by
Name of person making statement.
Name of person making statement. I
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i
I
(Sign ure of Notary Public-
W�1`: torMATRICIA ANN GRIF
nature of Notary Public- State of Florida ]
Commission No. cci37sza
- MY COMMISSION # GG1
e': (L W��2ES Septampar28,
%°P"'
lYtB
mission No. oGi37sza ::°`•' 4c:: PJJN�IA ANN GIR
•pc MY it
COM ISSION GG137
EXPIRES Se to ti
REVIEWS
FRONT
ZONING
UPERVISOR
PLANS
VEGETATION
SEATURTLE
—MANGROVE
COUNTER
REVIEW IREVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
20
RECEIVED
DATE
COMPLETED
Rev. 2/7/19