HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
1�Iyy�� II
Date: �e l ��I as Permit Number: NOou -ot4 LPl./'
RECET
Building Permit Application, 82020
Planning and Development Services
Lucie County, Permitting
Building and Code Regulation Division _. g
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: New Construction
pR®PROS� ), PRW U�EIV�E IT L�OCgaTslmOO IV P�n� i;"g,
Address: 53i'R S UM t l Q l�A fi P 4 Yn 1�1
PropertyTaxlD#::1` 11-10I- Dil-I' DI LotNo._�
y�'�
Site Plan Name: d Q nos N o m t f Block No.
Project Name: QdQ{ms r101T11 of Nuyrh".2!( Doyiotol IN(
�TisEa®rNFF.a,`OR�ax 1�f c
udrn�.�
k1 f: lh
n,
�
J a l�ca 4�rot� Q a
uv� c r CarCA
><rra+4�r�{y'�(
i 5Y
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
�t
I Electric Plumbing _ Sprinklers _ Generator L` Roof Pitch
Total Sq. Ft of Construction: 0 b 1 �1 Sq. Ft. of First Floor: ( S 12
Cost of Construction: $ D A a. 1 ':�, a Utilities: X Sewer _Septic Building Height:
pgg&pbJ .�A�pp. Y AS RS. ir4
!ER%LESSEE j?s rE �1�>y"3 ��°i,r sCp r� b � Kaj r' K "� ,a,9 ta. *�a =*• �Y FUXAn.�Nv"/eh�✓>v+S b+ttv ���'kbl3'N✓..,1�{w.41�2"t.%}LP..�XuFM� .;i�_��l�i VL Q�Y,�T��QCT�
'�wr%9✓ytisaY�_ i.n'��..+�s-xiXr'J'�it�k..>�fF...�tu�X�'i�nr�i�.�%
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: Address:3000 Gulf Breeze Parkway
_
Zip Code: 32563 Fax: City: Gulf Breeze State: FL
Phone No.772-905-8394 Zip Code: 32563 Fax: 772-905-8511
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
from the Owner listed above) 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 $7,500 or more, a RECORDED Notice of Commencement is required.
:vn fi'?'.( - rtc L> faCh28T# ",4^Y'F bt+w'lirYjR.x4riK 4S £Y u�9hbryr.�-uA,
sSUPPLEMENTrA{L'�`�CONSTR'UCTI®(V� IE-•4�1� W�`IJVF012�/I
:.x...�r '�'"..".� c�`xrk',.v�'�,.e.-.zn i��`�'".F.cyis'�$�`ar?.F;c�z'.c a-t3.'�.'�'i��'3�--��k:•!T
a'K'"•xT+�, b 4w SSwy i+'�a.•✓ i'�t`'i 4.-n t i2 r' ! �Ygs _jf Hit `�' r
TI®N.��' � :,y.�'xs��y`',`# � �' '�
✓�3�,r s�.s�c•.`.�*`._ ..3•e�c �'•.G,s*`H�%�=.�',`i��v 'j4 tv'^3`at��
DESIGNER/ENGINEER: _
Name: KeeseeAssociales
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 945 South Orange Blossom Trail
Address:
City: Apopka
Zip: 32703 Phone407-880-2333
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
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 COMMENCEMENT."
'Signature
-ewner/-Lessee/Contractor as Agent for Owner
Signature of Con a tor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sainl Lucie
COUNTY OF Saint Lucia
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 10day of ,11.l.YL.Q ,203Oby
this It) day of J1A_AN_X .20',=&�by
Y\IGm ftdarnS
�NdClW1S
Name of person making statement.
Name o person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Pr(Apra a AWA✓Wn/=
Produced
nUPNUdJlMl2 d /�16a7W�
(Signature of Notary P ljijc- Stat o Florida I
(Signature of Notary Publi Late o FI rids I
Commission No. I/1� u C/ �1 Se "'••.n
O 6 0y 1 (�la
/1
CMITIM16si No. �, I
yr �,, �• , FiCHARD DOUG
Ndary Pubic -.Isle
of Florida RICHARDDOUG
Coinlnssionq
0084821 r
q
"•,�nl'y.;•
dye y 9mm. P::
az
o9.,
'- Commission
REVIEWS
FRONT
ZONI
k
i"e i
VEGETATION
SEAJUR 2
Nd�I�VEEvIr
REVIEW
COUNTER
REVIE
REVIEW REVIEW
REVIE
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19