HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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
PROPOSED-]MPR'OVEMENT LOCATION: ".
Address:
Property Tax ID #::
Site Plan Name: "1
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CONSTRUCTION INFORMATION:
Residential X
Lot No.994n
Block No. oC
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas'Piping _Shutter's- L Windows/Doors
I Electric A Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:: I.30 U q . Sq. Ft. of First Floor: a313qA 0
Cost of Construction: $ 301A1 ot 0 O Utilities: A Sewer _Septic Building Height:
OWNER/LESSEE;
^CONTRACTOR:
Name Adams Homes of Northwest Florida, Inc.
Name: William Bryan Adams
Address:3000 Gulf P.reeze Parkway
Company: Adams Homes of Northwest Florida, Inca
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 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.
SUPPLEMENTAL CONSTRUCfION'�LIEN LAW INFORMATION
DESIGNER/ENGINEER: —Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: I(eesee Assodates
—
Name:
Address • sa5 sewn o�asa amssem rr�"
Address:
City: �oka State: FL
City: State:
Zip: 32703 Ph Oneg47A80.2333
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
CAUNEK/ CUNT KAu UK 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 contlict 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 nonresidential 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 COMMENCEMFNT_"
Signature of Owner/ Lessee/Cofactor as Agent for
STATE OF FLORIDA
COUNTY OF Saint Lade
The forgoing instrument was acknowledged before me
this AR day of BFY 1 L 20'�!O by
Signature of
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
thisLdayof 111>rl L .20_;;LOby
Name of person making statement. I Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Sign a of N tary P blic- State of Florida I
Commission No. GG137624
REVIEWS I FRONT
COUNTER
RECEIVED
COMPLETED
PATRICIA
MY COMMIS
REVIEW I REVIEW
Personally Known x OR Produced Identification
Type of Identification
Produced
PATR 1
�tNN GRIFFIN
MY CO ION # GG137624
EXPIRES Sentam6_ ____
PLANS I VEGETATION I SEATURTLE TWXffM
REVIEW REVIEW REVIEW I REVIEW