HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: a^VQ V-Q i
* Lo5 19
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
PERMITTYPE: New Construction
Address:
Property Tax ID #: 13 10- 1 0 0- 0 I 0 9- 0 0 Q- 1 Lot No. 5
Site Plan Name: R do M Rom / s A A Block No. o�
.
Project Name: 11U (A r r 1A 1 JU MI Di N 0 i t-\0 'w .M V F C I kl i
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
x Windows/Doors
Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: y y Sq. Ft. of First Floor: 1015 11 LP
Cost of Construction: $9 q s Utilities: L Sewer _Septic Building Height:
fE,r'
:WNER/L�EiSSE,E .
�':yH"L�*� fHa`�J.vt»ces� • yy,��.Y f;�
� p �
Name Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
Name: William Bryan Adams
Company: Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze State: _
Zip Code: 32563 Fax:
Phone No. 772-905-8394
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
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
---------- •—•• •" r--•—� -.• •••.+•_, o itluuL.e v1 wrnmencement Is requlrea.
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:
Name:
_ Not Applicable
Address: 945 South Orange Blossom Trail
City: Apopka State: FL
Zip: 32703 Ph one407.880-2333
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
City:
Address:
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 �Gvmi r Lessee/Contractor as Agent for Owner
Signature of Con ra >'or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF SalntLucle
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this day of i QYJ 20cdO by
this day of MCAV 20A6A>y
b� v G f\j -Rd a nn S
ry a 17d
Name ot 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
Produced
(Signature of Notary P liic-Stat o Florida)
(Signature of Notary Publlli tate o FI rida )
Commission No. O V I
I
(56 ,; , ROHARODOUG
`iJ0MMIssi No. 6
Vie," Notary ?;: ki 1
lite of Florida """" • RICHARD DOUG
410
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Yl,Onim.EXPIeslar1
,
; Commission
REVIEWS
FRONT
ZONI
° I Ntlo
VEGETATION
SEATUR fry.`
fiNd`i'�O EEXPir
COUNTER
REVIE
REVIEW
REVIEW REVIEW
REVIE
IhroughNa
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19
S Nor 20, 2021