HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: (� d�K ' v 1 �f✓
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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 Residential X
PERMIrTVPE: New Construction
PROPOSED IMPROVEMENT LOCATION:
Address: 5 Q o I O R l V cA F70 V V P I i Y(,4
Property Tax ID #: b Ir'dV1� -PU 0I-Cf - O LI G 3 - D O 0 - `-I Lot No.._�
Site Plan Name:_l l I I I,1 I 1 i� .� Block No.
Project Name: fWa rrirM ryi_rs of Northyw, FI DY00, I NC
INFORMATION:
Additional work to be performed under this permit -check all that apply:
X Mechanical _Gas Tank sPiping, _Shutters
�( Electric �( AW
Plummbing Sprinklers _ Generator
Total Sq. Ft of Construction:^ Ia�i q Sq. Ft. of First Floor:
Cost of Construction: $ A lQ U , I O Utilities: -Sewer X Septic
X Windows/Doors
!� Roof Pitch
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 No772-905-8394
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
It value of construction is,iZWU 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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SUPrPCEMENTAL�CONST�RUCTION LIEN IAW�INFORMATI®N
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DESIGNER/ENGINEER: _ Not Applicable
Name: KeeseeA souates
MORTGAGE COMPANY:
Name:
_ Not Applicable
Add Tess: 945 South Orange Blossom Trall
Address:
City: Apopka State: FL
Zip: 32703 Phone407-880-2333
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 COMMFNCFMFN7 "
as AgenT Tor owner
STATE OF FLORIDA
COUNTY OF Saint l ude
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrumenj was acknowledged before me The for�ggoing instrument was acknowledged before me
this -Z day of f b 20 aD by this A�I day of Fe b Wall) by
Byycw i9dary�S ByyGN -mums
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x
OR Produced Identification
Type of Identificati n
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Pubi - €F.locida 1
�K,} PATRICIA
Commission No. GG137624 IPATRICIA ANN
T on No. cc137624
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MY COMMISSION Al
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REVIEWS FRONT ZCXPIPPA
VEGETATION
SEATURTLE MANGRO
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW