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HomeMy WebLinkAboutBuilding Permit Applicationr__ All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f li Date: y Permit Number: • - Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X . PERMIT TYPE: New Construction Address: 'Dn I� MN Y T� pI J 1i Y h ''^^ 2 1 Property Tax ID #: - u D "I - D ( r d U' 3 Lot No. �3`1 Site Plan Name: QMS yy� IiV�/� 0) lS „' 'n 1rt, Block No. �1 Project Name: V1_I I IS d f ► I ,t f 'V o YrM / V tic f rc ( (N Additional work to be performed under this permit— check all that apply: YMechanical _ Gas Tank _ Gas Piping )(Electric Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Q Lr ")r 15 0 Utiliti( Name Adams Homes of Northwest Florida, Inc. Address:3000 Gulf Breeze Parkway City: Gulf Breeze State: Zip Code: 32563 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) _Shutters x Windows/Doors _ Generator X Roof Pitch Sq. Ft. of First Floor: a 33 a s: -Sewer Septic Building Height: 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 .1 V_,.._ .., L.,rr,.r UIi,on IN ;14ouu or more, a ntwnutu Notice Or LOmmencement is requfreo. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. ..�S'J.s'xtPP..4L.�EvJM:.µi -...EG NJi,TrtaAdL �+ .xOL 0N rteZL_.>., r Whtit ©RM+aietsL}q-.v. _JKrc:'iJ.'.t.tP4S h?• -M P J,a++r x Lr;M+,+'a tY="" Ys §^�.* Y- `3: d�Y ru .rS✓S'-R c. $.. d -. t [ � SSa..iy.�..oYi \rv.X �.[-: DESIGNER/ENGINEER: — Not Applicable Name: KeeseeA cciates MORTGAGE COMPANY: Not Applicable Name: Add ress: 945 South orange Blossom Tram Address: City: Apopka State: Ft Zip: 32703 Phone4BMM2333 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." as Agent STATE OF FLORIDA COUNTY OF Saint Lude The forgoing instrument wZIs acknowledged before me thisidayof MCAT .20aDby cxt,..) p-d Ckvvtis Name of person making statement. Personally Known x OR Produced Identification Type of Identification Produced (Sig of Notary Public- to IprMATRICIA ANN GRI MY COMMISSION # GGt Commission No. cc�wsza .:.red'PI)2E93eptambor2e, REVIEWS I FRONT I ZONING COUNTER REVIEW RECEIVED COMPLETED STATE OF FLORIDA COUNTY OF Saint Lucie The forgoing instru e t was acknowlecig d before me this day of C 1 , 20 It t3 r a- ty F-Fd ci, vvt S Name of person making statement. Personally Known x OR Produced Identification Type of Identification Produced nature of Notary Public- State of Florida ) M+.t✓ •, NO. GG73r624 �'•' �? P eR�'I�7±IA ANN MY COMMISSION # SUPERVISOR I PLANS REVIEW I VEGETATION S REVIEW LE I MR VIEW