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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: G' 2r�' Permitlll-Numl: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Co 4-10 JUN 0 'J 2020 Building Permit Application Ipermitting �7L.�artment Wit. Lucie County, FL PERMITTYPE: New Construction Address: Property Tax ID #: Site Plan Name: J Project Name: r Commercial Residential X Lot No. 35 Block No. I — Additional work to be performed under this permit- check all that apply: �/ Mechanical _Gas Tank _Gas Piping _Shutters XWindows/Doors I` Electric Plumbing _ Sprinklers _ Generator [1� Roof Pitch Total Sq. Ft of Construction:� Sq. Ft. of First Floor: q7� Cost of Construction: $ al 1 . 1 q a Utilities: x Sewer —Septic Building Height: Name Adams Homes of Northwest Florida, Inc. Address:3000 Gulf Breeze Parkway City: Gulf Breeze State: Zip Code: 32563 Phone No.772-906-8394 E-Mail: pslpermits@adamshomes.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: William Bryan Adams Company: Adams Homes of Northwest Florida, Inc. 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 State or County License CRC1330146 f value of construction is S2500 or more. a RFrnRnFn iu ri,..,r r,.......e...e......,.:_ .- If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. ;r ern xvry vr&.ra2kRRt„q• «s�w,m.n•< eS.rmM€ u 4rs`Ydae kx+L S� kSl€JPP�IVIENT"CONSTRUCT®NJ��IF1xLAWINf,©R.MPTt�O m. tea rcye:�aaY? .snyra^ a �zp :cr cgp'^n a r s r va'*" a"x is DESIGNER/ENGINEER: _ Not Applicable Name: KeeseeAssoclates MORTGAGE COMPANY: _ Name: Not Applicable Address: 948 Seam orange Blossom Trail Address City: Apopka State: FL Zip: 32703 Phone407-880-2333 City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Name: 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 'Lessee/Contractor for Signature Con Cor/License Holder as Agent Owner of ra STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Saint Jude COUNTY OF Saial Le°ie The fo oing instrument was acknowledged before me The fo1 �oing instrument was acknowledged before me this day of �1Q: LO 20by this s r � day of M04 20DLby BYVG Yy ftda Yin S F)Yy G t�j M G ME Name oV person making statement. NameTn making statement. Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification •Produced IC.I(J/10'IDX /f.SMfdXG� ✓/ vl� Produced /� q� �� 11� �AO` O.ntA! �.J at-rs_d Akl (Signature of NotaryP lic-Sttaat o Florida) (Signature of Notary Publi tate o FI rida ) Commission No. V1 O o I (SPI, I {^••., RiMRDDWG `{•a:`+ S:ARi$0tSi No. +°;w NolwjP. iic-. - • it�;• GOmm:88I0nR -`•,'Fo, Iale of Florida •••^ RICHRRD DGU G084921 >i�p•W�y; �.; GI ~n1'•i ro>` `: ybmpm. epos„az 2021 ' Canmksion REVIEWS FRONT ZONI """' ""°� VEGETATION SEATUR *N „� NdiRf�'�" REVIEW COUNTER REVIE REVIEW REVIEW REVIE DATE RECEIVED DATE COMPLETED Rev.Z/7/19