HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLEINFO, MUST BE COMPLETED FOR APPLICATION TO.BE ACCEPTED
Date: Permit Number:C-2-6&> '✓cpoc?�
0 RECEIVED
Building Permit Application May m 1 JVM
Planning and Development Services art�,en*
Building and Code Regulation Division Perstttlu , t.:
2300 Virginia.Avenue, Fort Pierce: FL 34982
Phone: (772) 462-1553. Fax: (772) 462-1578 CommerC.ial Residential X .:
PERMITTYPE: New.Constructiorl..
Address:
Property Tax ID #:, �.O .01 0,U 3 Lot No. _ _ 5
Site Plan Name: 19 d G m rU �m m i l l ,n � p Block No; 5_
Project Name: ia 0 U .. 1.10 m U 6 N o fi1,, Y l W 1 J 'F L I .►�1 l
Additional work to be performed under this permit'-. check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric Plumbing — Sprinklers _ Generator X Roof Pitch
Total Sq. Ft of Construction: a q 09 Sq. Ft. of First Floor:
Cost of Construction: $ a5l . 50 .0 Utilities: k Sewer _Septic Building Height:
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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 N0772-905-8394
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
V0 UC U LuInu uLuun, is acauu or more, a KtLUKutu Notice or commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 I7will,'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."
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2
- - •'��'«FFC�'�`' EXPIRES September 1
REVIEWS FRONT ZONING SUPERVISOR_ PLANS VEGETATION � SEA
'Rev.
DESIGNER/ENGINEER:-Not
Applicable
MORTGAGE'COMPANY: Not Applicable
Signature: of Owner /Contractor as Agent for Owner
Signature of Contractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sair,t�.oie
COUNTY OF saI.«u��e
The f r oing instrument was acknowledged before me
a u
The forgoing instrument was ackhowledged before me
this day of A n i 1 l , 20 by
this � day of !� Y B L , 20 �20 by
Name ofp'erson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known _x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signs ure of Notary Public- ta��:
• rf�,7'I�IC1eea ACJN
nature of Notary Public- State of Florida )
Commission No. ccisisza
MY COMMISSIpN # t3G1
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MY COM IS$ION # GG137