HomeMy WebLinkAboutBuilding Permit Applicationl'. .. .. ...
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 3�s� ` -gip, Permit Number: ci J' O -T(J
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RECEIVED
MAR 3 0 2020
Building Permit Applic t*
PCCounty, Permitting
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
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Address:
PropertyTax ID #: 3Wl/�
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Site Plan Name:
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Project Name:
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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
Electric X PlumbingSprinklers _ Generator ' Roof Pitch
Total Sq. Ft of Construction} Sq. Ft. of First Floor: �1
Cost of Construction: Utilities: —Sewer X Septic Building Height:
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O\NaqNERL�SEkc&:,
Name Adams Homes of Northwest Florida, Inc.
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Name: 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: 772-906-8511
E-Mail: pslpermits@adamshomes.com
Phone N0772-905-8394
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
Name: KeeseeAsseclates
MORTGAGE COMPANY: _ Not Applicable
Name:
Address' 945 South orange Blossom Tmll
Address:
bty: Apopka State: FL
Zip:3vo3 Phone407.eaod333
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is, hereby made to obtain 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 noh-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."
Signs ureof Owner /Contractor as Agent for Owner
Signature of Contractor License Holder -,
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Salnl Luda
COUNTY OF S.intLuae
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of FA ,20aDby
this _n day of r.2b ,20a0by
7�TN C1 N AdCA IS
7brukN li dams
Name of p rson 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
(Sign ure of Notary Public- to
InMATRICIA ANN
nature of Notary Public- State of Florida )
-
Commission No. cci3Tsza
'- MY COMMISSION # GG1
`•" .zc (�pPI}2E9 Septamt�ot 28,
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824
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mission No. ccI370 :';• 'j5e�%M
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MY COM ISSION # GGt 37
°a4'b,r e?,' EXPIRES Se to20
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
—MM—N—G-R—OVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 2/i/19