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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�y ' Date: Permit Number: Q02� 04 /�Cd �- Building Permit Application JUL 20 2Q0 Planning and Development Services Building and Code Regulation Division Pem-litting Dc ),,rtfneni 2300 Virginia Avenue, Fort Pierce FL 34982 c.t I L'CIG' County, ill Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re idential X PERMITTYPE: New Construction .) M i� fyN=u % 4 . 07 TJ®N��°("�,�! Px,RM P� , I „ � TWM d .;P{R�®VEM . rr 531 YO Address: Pf 1(� Property Tax ID #: 1 I I" l D I' O U 3 S- O D O- LI Lot No. Site Plan Name: d a m s � � m i j Block No. /F7a7 VI Project Name: 11Q (Y J jiMI J o f N o rrh Njj r f j o r 1 do , I IV( �DETIP � YkN�,`F,p a��n>, ��+'+M1wF�$Sn'#A9: YI�EwMP4w�n�Y?Yt9WF . ��4#APg`P.iifM S Y nY�" s &�4G���x�i�i4�Y1K` `�d eY oku<;�k a Y uµrG i�,»i,,., 35y �'.W kY��lj•`v��"1�1'A�:����iP ��+'�ra�i� �yr .+GtRi .'""SPA. of JF'X�,mtY N>+�m:S1efi'I:"'Nri::rrS}..iH��1y'�P:'.�,'�a'J }h..'V2'ri..iin�'.+'V��45.:yo$fra'bS�'.�4'f4}C�9�� Additional work to be performed under this permit— check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors l I Electric Plumbing _ Sprinklers _ Generator _L Roof Pitch Total Sq. Ft of Construction: a D1 a. Sq. Ft. of First Floor: (L{ R cj Cost of Construction: $ a3�i , �tM1( DO Utilities: XSewer _Septic Building Height: Q$�i^k'"T 4 i'+ +v t+ Y'etl'frtt'YSr^` l4�tin w Ck' G D+tC'4 M^Y tt%nf^iN^v 4uy. Y+• OWNEf2%LESSEE' �w°f fxxrc Y,g Ik ' pz COO NTRP'CT®R * a t r+ K " 14 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 No772-905-8394 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. L YX W'e ne+N.nrti +w.ez'�.ufea�}`t�. •wrY"EFa"�kr w�anf C sh �m rc�.,x.�vn w `S,t��PyP, ��VIE�1�7�,4•!. C®,,,�Ny,,S�TRUG d®N�FpENH�+L y...i��N L„�iit�'. S�v.. �F"`�..{a ��.�,ari�,-*,��i�`+r%. ..k-aC:';":k1.rY*7�r. `r"a•',.s;3h�f�'n',4A��JS�,x q��,er+:aie�5y& r^ TT r.Zb a�,�*75s �h�'�i✓�j"n'r} xr C,zk f4t �`sar F©RM Tf �v�..�',ri*ti�`,��'�F��?m�`,r, 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 Phone407.880-2333 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 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, 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 Con Holder f-Owner/-Lessee/Contractor as Agent for Owner Signature of ra for/License STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Salntlncis COUNTY OF SxintLude The forgoing instrument was acknowledged before me F4 The forgoing instrument was acknowledged before me LI this c9 day of c ILL b.1 , 20AC3y thisa day of 20_Oby b-I G �J ftd a YY\ S 1 Yy CA VU G ME Name o 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 �L!'1%tA9 DX ramA ✓rtohtNi�— Produced /n1 GG�� _'n_' R t� A o5l r►Jrn1 oL (Signature of Notary P lic-StCa/t�10 Florida j (Signature of Notary Publi Late o FI rida ) O B 6 Oi I Commission No. VI (SPER07;",, niCHARCDWGI ACOMMiSSi No. '•=°;t pe•' NaaryAalc-.tale of Florida•••• RICFIARDDOUG �\1e Crvn!ns ionk G004821 ybonim. �ap� k°°� es'. at n ; • Co nmiss!on REVIEWS FRONT ZONI. VEGETATION SEA TUR Ea,r NdiR@9WEEKpir REVIEW COUNTER REVIE REVIEW REVIEW REVIE ;, mayh na DATE RECEIVED DATE COMPLETED Rev. 2/ // ly