HomeMy WebLinkAboutBuilding Permit Application-All AkPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7 , /�
Date: ° �- Permit Number: cam° �"/
•' RECEIVED
Building Permit Application SF' 2 zo2o
Planning and Development Services
Building and Code Regulation Division ftrmlttiny Be artment
2300 Virginia Avenue, Fort Pierce FL 34982
St. I Wq unt;y
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: New Construction
m�PROP�®�'SED IIVI'pR�:�VE�ME�NTt L ;CATI`O°�'�"���f'�� . � .y h �, : r � � �- ,�r;;���� rf .. � ���. `�_:�' t•
Property Tax ID #: O O - U _ - Lot No. ,
Site Plan Name: M1.1
OI�rYI ,P S Block No.
v�/1y�/
Project Name: 0 I 1 �I I I d 1� 11i 1 r Ch N
DETAI aY,
3 s:SITr 'uxs ai 8r r r
�E'® R+IfPi'I®N®�F'�W{aR.WIN��
�x. vt *p. r P'it� i�".ddt.' kw.c-k�.r•'yn, �;;- ,�n.?r„p,
i)10 V 0 o M1 1 K0tr]r fmMJ
��^'7, :j .. 3 ') �� , . ; �•ti"(< s5� �iv'��`"tt y�i�?u �^ gF r , ,. r �"r '`a;;, va '}�i f� ";•t �%`�✓'.•gZ�fns 7`s"�-t'` '� "�,;;y�tk� : r'e-J'u ?, $" .c� ". _ to :,wP.'i ,'i .
�CO N,STR l�1 CTI,O Nil N � r ,s•� � �' � � -� � � 4.t ' a �. h fl t., fl .,��` h � �` w����'�� �a� dt-(r7i=��+�' J � v3' t ��, �4`v �.Fr�`..✓ 2 ,'rr? 9�r tz �`� .+� '� , �',�_'.i.1xS.�;6,s��,"? �fty.,,..+.:�5��ii�•.k�s,�k.5z;��:�.+.r�+4r �•�va�" ��5.a a_b ,• , c�.., .. �`,5 3��.,1 �. �r� c� f`
,:FLFT"�'. r*J .i � ^� '� $,....��tif..S^��i..,:t���, b �,ik1XY�F4 y, _.. '�:.•;�
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _Shutters A Windows/Doors
Electric Plumbing _Sprinklers _ Generator � Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: ? 1) 2()
Cost of Construction: $ 2 q (j I q O C3 Utilities: K Sewer _ Septic Building Height:
®M oafi
}
ER/LESSE,E-��';� ,`��(--�r�� ' .� . , �rr � °i;� :�, � { x � �'9 � „�,`���`,� • �, .�:: r e�,t '�;'n� f , 4,..;%.,'
WNi zy CONTRACTOR {� £„
•+hdd'.1ta rw,,:*.7�•ni,?,`,5'."ta3a,K..r�.,rz��ti�✓.
rtl J...-'f,..'!%s.iw..r�� �?^Fz. 3°w..i.n�-�,✓-a,r.,,a �U: JXa. , .Jx�Ya.,C:1: tc,
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 N0772-905-8394
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.
1URPLEM+§EN
1�a�i,.l�
DESIGNER/ENGINEER: _ Not Applicable
Name: Keesee Associates
Add ress: 945 south Orange Blossom Trail
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: Apopka State: FL
Zip: 32703 P h o n e 407-880-2333
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 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."
Holder
Signature 19wrmr/-Lessee/Contractor as Agent for Owner
Signature of Con ra for/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF saint Lucie
The forgoing instru[p�l ent was acknowledged before me
The for oing instrurpent was acknowledged before me
this day of J.Q, p �i 20 2 by
this day of', 20 by
b�y G I\J -Rda YY\ S
F)ry a tl V-1cl Ct ME
Name o eperson making statement.
Name ot 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 lic- Stoat o Florida)
(Signature of Notary Pub(lli tate o FI rida )
Commission No. O D I (56�j�;.';
No. 6 1
V► • i<iC,1ARUD0UG
tP •
�JOHRSONssi
Ivo!ary? „iic-,t2lecfFlorida
Canimssion k
RICL DOUG�
" G 084821 =
REVIEWS
FRONT
ZONI
omm. Up
Y111151.w r Niiaw
es, ar ,
VEGETATION
; , " -
SEATURy'
n " = Commission
14tiNd�tf�'VEExpr
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
O
REVIE
" ' ihrouahNa
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
Florida
2021
Assn.