HomeMy WebLinkAboutBuilding Permit ApplicationAAAPPLICABLE'INFO. MUST BE COMPLETED FOR APPLICATION.TO.BE ACCEPTED
Date: Permit Number:. •� •
(455
;r
o
Building Permit Application
Planning and Development Services
Building dnd:Code Regulation Divisidn
2300 Virginia:Avenue, Fort Pierce: FL 34982
Phone: (772) 462-15.53 Fax: (772) 46271578 Commercial 'Ribsidential X
PERMIT TYPE:
NeW .Construction
� rr^.3a '47'�'`-t.rr -T.:'? e;�y"":'°s'�"� i .�.�
' .�%i'f"%+r�r� i S .t..;'!.r`�.�.-•s?s^'4y,Fz�,.r rr{� �e,?+s shy;R M�.:ary�rr;;
P RO P�®S�EDI M PARf�V ECM NTL ,CATrI '� N q Cy..:�.r�i� ,, '�,.r ,r..o,:.•._., a.". } ,,ia,':,:,,..1.;r,'4r.:.adt7.'`...4;',•'�.'".t..b{�:ef. t, +},
Address:
Property Tax ID #: RIMS
U - D D D - 1. Lot No.. 3�
Site Plan Name: VI�_.fr1 f ft0 y Block No: _50
Project Name: (1 nY1 J � 1 (� b (t r C) r I' ct. I IV
.ar"YI a�,': Y�',�f ..;..��3r � y:%�c�4S4i'�. =F'�d'.�ri+; . � .�: ,� : �`�^` ,e� ti`:'3:�' its 5 ,.`T l i;r`ar #" r, �S S x aF^ '+} •a�r;^� t6?. _'.r.-. - r 7 e.. r .,, w� :rr•;
,?'f`"". r,� . § .l -'fif r a r• .3jty«- vi ^�.? „2x r ...„r e �u- r . ``G Fa,F,
�E�T�AttLE®��.{{DE�SCR+I'PTI�®�N�, .�`�.,,�;,�,.�r,;�;�,�� ;..� ..��� �:;��'���'� ;�:•�:� �xtiy:� .��,y5�, ��p`;.-��'�"Y�,��.�,,,�
� v R.`4 < 4-.d7 _. r Via. t�� F. W O R iC �w�. 2 � rh.$ a '�s��'�F � n�T.��R` �+ Kh-s� ::•.,�i{ r', +t _Q}�, r �'� � � A +t �q ^�"-a""�, tTk,,,�i_�� S�.�br.,,",fl.�.:...3d,�°':,.•,.`+,�k`�w'^. x,.;?is"v.�#x'�'�, �..,�1',:r§4 psi.'rnfk^�.ix&���':�`�'°���5,�x����1F��':.,e::�.,i'.kiv;�;,'�sa�yr%�6`•.}'vi�*��k�..''i�'L,+o�'u'c"4 d4 �trA�'.'.su��to.�i�x$nB��Y1"�3#
A•
+5.:�•;;^}n���;4ft9�;�:_;yd���,�Y ;. * r�rh K �r��^��� a .r�. � �, ,� z ;s.€� �,vt�sr� x�^' c,, w y � .:�, K f
-
�CO'NSTR.UCs�
141
Additional work to be performed under this permit- check all that apply: y
_( Mechanical _ Gas Tank Gas Piping _ Shutters /\ Windows/Doors
Electric - )�Plumbing' _ Sprinklers _Generator X: Roof_ Pitch'
Total Sq. Ft of Constructions: �� D Sq. Ft. of First Floor: (% D I D
Cost of Construction: $ . 9S 9 , 15 D Utilities: _Sewer X Septic Building Height:
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.
-,-
a :�A�:i:''"�i�'rR�=r4t"� 't'� � sMCA
z, ?
�hN��W'��r�f ��yk.,,���
C,a.rs,- �a,ra�r�S,�.�.�t:.
�h. �3''r�+�"4.`•,{��'�iri'��
�-� �,� � +z;��,�,� ��a,� � ��,
� �
�; '+�s� l
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:_
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-Marl Pslpermits@adamshomes.com
State or.CountyLicense CRC1330146
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGECOMPANY: Not Applicable
Name: KeeseeAssociatesName:
. Address: 945 South Orange Blossom Trail
Address:
City: Apopka State: FL
City: State:
Zip: 32703 Ph One407-880-2333
Zip: Phone:
FEE SIMPLE TITLEHOLDER: = Not Applicable
BONDING COMPANY- Applicable
Name:
_Not
Nahie:.
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.
Inconsideration 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,sereen 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 BEF..ORE RECORDING YOUR NOTICE OF COMMENCEMENT. "
76
Signature of Owner /Contractor as Agent for Owner Signature of Contractor License'Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF Saint Lucie COUNTY OF Saint Lucie.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
ty
this day of 'FA b , 20Q 0 by this _n day of Ft b 20al 0 by
ry 111-4 a v� TTU a )nn S 5ri1 G I-1 ifs (1, Ck uV\S
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR,Produced Identification
Type of Identification
Produced
(Sign�f Notary Public- to _ Iprlr'tA�i'RICIA ANN GRI
= : MY COMMISSION # GG1
Commission No. GG137624 " •.^ �lde` ( �I�tESSaptomlmr2a
Type of Identification
Produced
"!Sf nature of. Notary Public -State of Florida )
624 .."
"ar Np r. �
*I 'mission No. Gc�37s2a P��--���j��roro����-'ff IA AJo N GRI
iU1Y'COMMISSION # GG1
REVIEWS COUNTER REVIEW FRONT ZONING SUPERVISREVIEWOR I RE VIEW I VEGETATIEVI WON I SEAT EV EWLE MR VIEW
DATE
RECEIVED
DATE
COMPLETED