HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: ay - to (J
Building Permit Ap
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
PERMITTYPE: New Construction
Address:
Property Tax ID #:
Site Plan Name
Project Name:
CoNSTRUCTI NAiINFORNIAT10W
1 "31 Q1 i1 �Mn sty � Y 02.1 4a4
ion MAY 7 2020
Permitting Department
,;�&.,.Ltllc�e County, FL
Lot No. 3
Additional work to be performed under this permit- check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
kElectric XPlumbing _Sprinklers _Generator _yKRoof Pitch
Total Sq. Ft of Construction:(W Q Sq. Ft. of First Floor: (x � r�cb 1
Cost of Construction: $ M9. 90 Utilities: k Sewer _Septic Building Height:
OWNER%LESSEE -
CQNTRACTOR
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 Nd 772-905-8394
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone N0772-905-8394
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.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Keesee Assoclates Name:
Address: 945 South Omnge Blossom Trell Address:
City: Apopka .State: FL City: State:
Zip: 32703 Phone407-880-2333 Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable I BONDING COMPANY: _Not Applicable
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contiict 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."
l
Signature wner essee/Contractor as Agent for Owner
ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Samt LuAo
COUNTY OF saint Lucie
The f r Ding instrument was acknowledged before me
The forgoing instrunyg t was acknowledge before me
_Z
this day of 41 V I L . 20ao by
this day of TL r I L by
5hl0ri ftdGm4
by 0V1yw(Amf
Name bf 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
4"�
(Signs ure of NotaN Public- State of Florida)
(Signs re of Notary u
Commission No. cct37sz4 ;�:• ' _(�' �RICIAANN GR
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PATRICIA GRIFFIN
FLfdQi ission No. cG13 s f, :' MYCOMM
. MY COMMISSION # GG
37624 "'�?oFi�ti,,� EXPIR # GG137624
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September 26
REVIEWS
FRONT
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VEGETATION
SEA TURTLE
MAN
ZONING
COUNTER
REVIEW
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DATE
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DATE
COMPLETED
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