HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: �' a� o/�% Permit Number:
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_-- Building Permit Application JUN 2 2 2020
Planning and Development Services
Building and Code Regulation Division Permitting 'DG-,partneient
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lode County, Fl._
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential--X i-�—
PERMITTYPE: New Construction
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Property _Lot No. Ian
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Additional work to be performed under this permit— check all that apply:
_ Gas Tank _ Gas Piping Shutters %� Windows/Doors
.t'Mechanical _
I` Electric PlumbingO
_Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 193 2 Sq. Ft. of First Floor: `Ll O 1
Cost of Construction: $ c1LlLI . Sol $ Utilities: x Sewer _Septic Building Height:
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Homes of Northwest Florida, Inc. Name: William Bryan Adams
:3000 Gulf Breeze Parkway Company: Adams Homes of Northwest Florida, Inc.
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lf BreezeState:
Address:3000 Gulf Breeze Parkwaye:
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32563 Fax: City: Gulf BreezeState: FL
o.772-905-8394 Zip Code: 32563 Fax: 772-905-8511
E-Mail: Pslpermits@adamshomes.com 7729058394
Phone No - -
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.
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DESIGNER/ENGINEER: _ Not Applicable
Name: Keesee Associates
MORTGAGE COMPANY: Not Applicable
Name:
Address: 945 South Orange Blossom Trail
Address:
City: Apopka State: FL
Zip: 32703 Phone4W-Ba0-2333
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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
-Owned-Lessee/Contractor as Agent for Owner
Signature of Con ra Cor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF saint Lucie
The for oing instrument was acknowledged before me
Ydayof
The for oing instrument was acknowledged before me
this may ,21by
this7dayof TYICLy ,21by
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Name ol 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
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(Signature of Notary P lic-StCa/tao Florida)
(Signature of Notary Publi tate o FI rida I
Commission No. O V 0 UI I (Sell')'";;•,.
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DATE
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DATE
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Rev.2/7/19