HomeMy WebLinkAboutBuilding Permit ApplicationI
All APPLICABLE INFO MUST BE CCmirLETED FOR APPLICATION rrO BE ACCEPT&r -
Date: Permit Number:=2: V�`t /
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
A
N T P
Building Permit Applicati�d ?1--a
Commercial Residential X
PERMITTYPE: NEW CONSTRUCTION
PROPOSED IMPROVEMENT,LOCATIQN,
daY. D,n x.M
Address: 5000 SUNSET BLVD
Property Tax ID #: 3402-608-0244-000-1
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST, FLORIDA, INC.
rHS / 2 CAR GARAGE
l; CQNSTRUCTIONI�INFORMAwTI`QN:
Additi'nal work to be performed under this permit- check all that apply:
✓—Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: ^ d %;l,Sq. Ft. of First Floor: _
Cost of Construction: $ 256,150.00 Utilities: -Sewer _Septic
Lot No. 14
Block No. 47
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE.•' -6
CONTRACTOR
Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Address: 3000 GULF BREEZE PARKWAY r
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000,GULF BREEZE PARKWAY
City: GULF -BREEZE State: _
'Zip'Co'de:' 32563 Fax:772-905-8511
Phone No.772-905-8394
City: -GULF BREEZE ,. State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone No 772-905-8394
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;CONSTRUC
LIEN«L`AUV
INFORMATION
''
DESIGNER/ENGINEER: _
Name: Fos ENGINEERING ASSOCIATES
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 249 MAITLAND AVENUE, SUITE 3000
Address:
City: ALTAMONTE SPRINGS
Zip: 32701 Phone321-972-0491
State: FLORIDA
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 Count yy 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, 1 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 of Owner/ Lessee/Contractor as Agent for Owner Signat actor License Holder
STATE OF FLORIDA
COUNTY OF SNW LUCIE
STATE OF FLORIDA
COUNTY OF SAINT wCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 14 day of NOVEMBER . 20L by this 14 day of NOVEMBER . 20LI by
WILLIAM BRYAN ADAMS WILLIAM BRYAN ADAMS
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
(Signature of Notary Public- State PATRICIA ANN
p r,
Commission No. GG137624 �t edgyCOMMISSION #
'•:wTd!:t' EXPIRES Septemix
Personally Known x OR Produced Identification
Type of Identification
Produced
,Z—g—aplure of Notary Public- Stntp nf-Flnrida j
No. GG137624
REVIEWS I CEGETATI
OUNTER I ROEVIEW I S REVIEWUPERVISOR I REVIEW PLANS I VREV EWON
PATRICIA ANN C
h `WkIMISSION # C
EXPIRES September
SEATURTLE I MANGROVE
REVIEW REVIEW