HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ?- j q• ->d Permit Number:
Building Permit A
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
FEB 19 2020
Permitting Departmen
St. Lucie County, FL
PERMITTYPE: New Construction I
Address: 8I `2 9
Property Tax ID #: 1311 - 700 - O IW - OOO - °7 Lot No �ZOW-s
Site Plan Name: HdUr»S Horn -CS Block No
Project Name: Pdcirn S Hcm-eS (X Nor+hwest f (Or Ida , mo.
DETAILED DESCRIPTIONOF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
%Mechanical _Gas Tank _Gas Piping _Shutters X Windows/Doors
X Electric X Plumbing _Sprinklers _Generator 1 Roof Pitch
Total Sq. Ft of Construction: WN �1: <I Sq. Ft. of First Floor:
Cost of Construction: $ 3i� IL 6g1 . jl{ . _ Utilities: XSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Adams Homes of Northwest Florida, Inc.
Name:William Bryan Adams
Address:3000 Gulf Breeze 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
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.
_Not Applicable I MORTGAGE COMPANY: Xi Not Applicable
Name: Keesee Associates Name:
Address: WSouth Orange Blossom Tmil Address:
City: Apopka State: FL City: State:
Zip: 32703 Phone4D7A60-2333 Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^ Not Applicable
Address:
City:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name:
Address:
Zip:
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."
as Agent for Owner
STATE OF FLORIDA
COUNTY OF saintiuGe
STATE OF FLORIDA
COUNTY OF Sakti Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-Wdayof 2020 by this—Wdayof QXtQ tA 2020by
Name of person making statement. I Name of person making statement.
Personally Known x OR Produced Identification I Personally Known x OR Produced Identification
Type of Identification Type of Identification
(Signature of Notary Public- Sta ture of Notary Public- rA f%jorl OMMISSION # GGt
' ^' '• PATRICIA ANN G IFFIN
GG13762d ';+'•' 4`F' dPc E September 26,
Commission No. - tvo COMMISSION#G '10 &2 Isslon No. GG137624 o.R,•� ' P
-�';i•a,;,i ` EXPIRES September2 ', 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
EVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/i/iy p 0