HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
Date:
Permit Number:
Building Permit Appli
Planning and Development Services 1
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1S78 Commercial
PERMIT TYPE: I
Address: 0-10V CJ&n 6w
Property Tax ID q:X31/ —70/- oog.2.
Site Plan Name:
Project Name: f /Y1S L/,M/A Al
• ���� edc' worK to be performed under this permit —check all that apply-
/Mechanical Gas Tank
t`// Gas Piping.'1 _ ShiuttQis
Electric Plumbing —Sprinklers
._ _ Gdneritor
Cost of Construction:
Total Sq. Ft of Construction:
Sq. Ft. o FirsLFloor:
$%(�
Utilities: Sewer , �epl
NameAdams Homes of Northwest Florida, Inc F
3000 Gulf Breeze Parkway Address: City: Gulf Breeze Zip Code: 32563 State: Fax.772-905-851.Phone No, 772-905-8394E-Mail: Pslpermils@adamshomes.com
Phone No
Fill in fee simple Title Holder on next page ( if different E Ma IPslr
from the Owner listed above)
State or Cc
If value of construction is $2500 or more, a RECORDED Notice of Commencen
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is
nDEC 17 2919
ST. Lucie County, Permitting
Residential X
Lot No./tip
Block No. 6
Windows/Doors
Roof Pitch
Building Height:
n Adams -Qualifier
lames of Northwest Florida, Inc.
Breeze Parkway, -- .
State: FL
Fax:
8394 —�
adamshomes.com
,nse CRC1330146
---..r r•.....,,c
Name: Keesae Asspdates ArchllecWre [Iealgn, Planning
Address: 945 Spelh Orange Blpsspm Trail
City; Apopka
Zi : anon State: FL
p Phone4o7-eeo-2ao4
FEE SIMPLE TITLE HOLDER: Name: Not Applicable
Address:
City:
Zip; Phone:
MORTGAGE COMPANY:
Name: Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: NotAppiicable
Name:
Address:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to:obtairia permit to do the work and installation as indicated.
I certify that no y work or installation has commenced prior to the issuance of a permit.
which Is In contli makes no
any applicable Hme Owners Asssociationl ru esauthorize-the
bylaws or andp permit holder
that build
ay restrictbor pr hlbit 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 t6t'l 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 cohcui�ency review: room additiohs;
accessory structures, swimming pools, fences, walls,,si' scree
accessory arid accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TPOSTED ON THE JOB SITE BEFORE THE
WICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
WITHYOUR ENDER OR AN ATTORNEY BEFIORF RST RNSnpC�T�ONv IF YOU INTEND TO OBTAIN FINANCING, CONSULT
as Agent for Owner
STATE OF FLOR
COUNTY OF�n t
The forgoing instrument was acknowledggd before me
this&day ofZ3 p ,2ryf by
Personally K ✓ OR Produced Identification
voe of Identifirotl.
plgnature of Notary Public- Saigp Florida 1
�""°''
Commission N PATRICIA ANN GRI
G .g� %t
v_, : IJ�8MMISSION # GG1
EXPIRES September 26,
Signature of
STATE OF FLOR
COUNTY OF__t_')j2jA_t I,
The forgoing instru e t was acknowledged before me
thiy& day of � /1�/2 2
,04 by
-- amee of
Nf per making statdmen[. '
P onall K ✓ Type of Identification OR Produced Identification
Notary
State
PA7NA ANN GRI
MY �Ltt ISSION # GG1
EXPIRES September 26,
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