HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR AP I TION TO BE ACCEPTED
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Date: �%' s' �' .."� )--®----Q I12
Permit Number.
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• • `J I 0 C T 0 i:: 2020
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- Building Permit Appli ' tion
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Planning and Development Services E'r' io a j trri e n t
Building and Code Regulation Division to LL! 9r i La )7 �[�� �'�
2300 Virginia Avenue, Fort Pierce FL 34982 -----� / r
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: New Construction
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Address: �7J�1 SG rl Le N (/l.C. t tb P l
Property Tax ID #: 131 I - �
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Site Plan Name: OMS o Block Not
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Project Name: PG I B �/t S H u m l f N� j( �"� ��i is F 0 V( d C4 ) C.
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Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank-' _ Gas Piping _ Shutters Windows/Doors
Electric Plumbing _ Sprinklers _ Generator Roof Pitch
n: 14 bpi Sq. Ft. of First Floor: p Z
Total Sq. Ft of Constructi1215u,
C2
Cost of Construction: $ L J u i Z O D Utilities: X 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: 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 No 772-905-8394
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.
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DESIGNER/ENGINEER: _ Not Applicable
Name: Keesee Associates
MORTGAGE COMPANY: _ Not Applicable
Name:
Ad d ress: 945 South Orange Blossom Tram
Address:
City: Apopka State: FL
Zip- 32703 Phone407-880-2333
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 coven ants, 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 1 will, imall 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, sigrfs, screen r-ooms 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 OP COMMENCEMENT."
Holder
Signature f-13vvfmr/-Lessee/Contractor as Agent for Owner
Signature of Con ra or/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SaIntLucle
COUNTY OF Saint Lucie
The for oing instru ent was acknowledged before me
t �r
The f foing instrument was acknowledged before me
this day of • 20 Z0by
this L day of lC) C t 201 Oby
EYN GC Y\J fWa rye S
F)ry a tl T10 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- St�a/t o Florida)
(Signature of Notary Publid3tate o FI rida )
Commission No. O D I
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(SMZI�
�9RNNmissi No. ��•�
_ • Coy n:ssion k
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REVIEWS
FRONT
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lionat t
VEGETATION
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SEATUR ly,��
El N GA0 xpir
COUNTER
REVIE
REVIEW
REVIEW REVIEW
REVIE
l�
FVIlhrouunNa
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19
Florida
2021
PERMIT # I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AOREENIE.NT
l01 \ Cl U 10ij5` l t 1 [1 1 U - have -agreed to be
(company Name Individual Name)
—
the Hooting Silb-contractor for Adams Homes of Northwest Florida, INC
(Type of Trade) (primary Contractor.)
For the project located at - Ill S U 0 b J YV CU .f "PL
(Project Street Address or Property Twx ID #)
It is understood that, if there is any change of status regarding our particiliation with the above mentioned
project; the Building and Code Regulation Division of tt. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
e
CON'FRAC'1' a i7riE-(Quulifirr) - SUB-CONTRAC'r IGNATURI )iialifcr)
William Bryan Adams
PR1N'r NAbtli --
COUNTY CERTIFICATION NUMBER
State of Florida, County of St. Lucie
fate foregoing Instrument s signed before nu this Z. day of
wit
_ O Cz ZDby William Bryan Adams
yrtio is personally known -1-or has produced a
as Identification.
STAMP
`` Signature of Nntary Public
naV� Moo Y-
Print Nance of Notay Public
�.1117 Notary Public State of Flprida
Hannah E Moore
My Commission HH 017099
Rciiscdllll(1201G �7pwd' Expires07/01/2024
Ao� cim. q C-`lEri 6 g tk
PRINT N NIF �I
COUNT)' CERTII'IC.ATION NUti1BER
State of Florida, County of St Lucie
rbe foregoing instrument was signed before me. this 2 day of
ocr 2u?obyJoVUnny�iQJY[1g N(Atq
iw•ho is personally known -A—or has Produced a _
as identification.
(Si
.1A/IypA L 1 W O�s'rnNIP
�nahrce of \Diary Public
ffonwn mw
Print:Yarn. of Notary Public
lg*% Notary Pubko State of Flppda
Hannah E Moore
"� = • My Commission HH 017099
'rapt Expires07/0112024
PERMIT # I I ISSUE DATE
PLA1®NING & DEVELOPMENT SERVICES
Building & Coale Compliance )[Division
BUILDING PERNTIT
SUBCONTRACTOR AGREEMENT
AAPEX Electric
(Company Name/Individual Name} — have agreed to be
the Electric
(Type of Trade) "---' --•- .. Sub -contractor for Adams Homes of Northwest. FL, INC
(Primary Contractor)
For the project located at _ 53r1 � S OU I L
(Project Street Address or Property Tax ID x)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
TRACTOR SIGNATURE (Qualifier)
SUB CONTRACTOR SIGNATURE (Qualifier) -"
W. Bryan Adams o 1
PRIM NAME -
PRINT NAME ___. _--_-
29179
COUNTY CERTIFICATION NUMBER -
State of Florida, County of St LUCIe
The foregoing instrument was signed before me this 2 day of
oC202Qby W• Bryan Adams
who is personally known or has produced a
as identification.
AJ
Signature of Notary public
n n� h IMt% Y-g
Print Name of Notary Public
.yi't =StRtOdte of Flpnda+P er H 017099R isp4
COUNTY CER-rtFtCAT�O�N�IyBER
State of Florida, County ofE& t L�%e—
The foregoing instrument was signed before me this _2 day of
by
who i§ personally known N.-or has produced a
as identification. y
1 STAMP \— , �rauB� JAJMLHARNER
•.• c
° # ,
tinture of Notary Public MY C6It %N # GG 089122
EXPIRES• April 2, 2021
9,eOF F`Oe� Bonded Tt1'1, Bud!.el Notary SE(V102S
nt' nt Name of Notary Pu he
I ;
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
41-ela .141r ;
(Company Name/I ividual Name)
the HoCha,-- &I
(Type of Trade)
have agreed to be
Sub -contractor fore*1Q "d ®9 Aft�R' AL F T
(Primary Contractor)
For the project located at 533�1 S a, i) �� ! nl n m P L
(Project Street Address or Property Tax ID #)
It is understood that if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie Coul'''Ity will be advised pursuant to the
filing of a Change of Sub -contractor notice.
�� CONTRACTO�RS NATURE (Qualifier)
4PRI,'
AMANIE-
1-UUNTY%-r-K1it'1UATIO,NNUMgER
State of Florida, Countv of Q( � (J
The foregoing instrument +vas signed before me this
p� � ��� 2 day of
L V C 20Zo byy'o-Ji L/l-ttiL that
+vho is persona y n I®or has produced a
as identification.
Qze
Signature of Notary Public STAMP
t r' It
Print Name of Notary Public
PATRICIA ANN GRIFFIN
c _ MY COMMISSION # GG137624
Revised II/lC>/2016 EXPIRES September 26, 2021
_C RA NAME TOR SIGNATURE Qualifier)
E (
c o uISS0
PRINT NAME
COUNTY CERTIFICATFON NUMBER
State of Florida, County of j—.qL {
The foregoing instrument +vas signed before me this Z dry of
0C fi---=4 ab, el( Russo
who is persoriall • vn &000'eor has produced a
as identification.
Signature of Notary Public STAMP
PNmaa�P.bli,�:��y
;�;?►"Y'•'!ecr: PATRICIA ANN GRIFFIN
My COMMISSION # GG137624
EXPIRES September 26, 2021
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code: Compliance Division
SIA M 1 n%
the
(t ompany Narpe/Individual Name)
(Type of Trade)
For the project located at
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
LLA VV Sc12,0I:CC& .ZN
have agreed to be
Sub -contractor for Adam Homes ofNorttrire Metritta G
(Primary Contractor)
(Project Street Address or Property Tax ID #)
F�
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CO R SIGNATURE (Qualifier)
Adam Homft of NN wfeM Borsch, Mc.
P— I NAME
COUNTY CERTffICATIONq
State of Florida, County
The foregoing instrument was signed before me this 2 day of
Z.-& by William Bryan Adams
who is personally known or has produced a
as identification.
abeotNmai7 f'utitic —� STAMP
SHELLEYA. SEPUI_VEDA
Print Name of Notary Public
:+'•°•!c.. SHELLEYA. SEPULVEDA
• MY COMMISSION # GG 262014
=',; p EXPIRES: January 25, 2023
f �� Bonded'Dru Notary PWIc Undwm-;Im
Revised 11/16/20
SUBj�CO�NT� SIGNATURE
'(Qual+fier)
PR rVX n't(::�Jt
COUNTY CERTffICATION N JNIBER
State of Florida, Co,uoty of 3'r. u-AGQ
The foregoing lostrumot�was signed before me this Z day of
V C 21 hY ✓l�e,tn'lTr1 �-)jig _eAneZ
who is personally known ✓ ar has produced a
as identification.
Signature of Notary'Public
STAN&
iC_ nrra Qt9tCk.S t7ohnSG✓1
Print Name of Notary Pv lic
F200nded
HARD DOUGLAS JOHNSON
lary Puhlic - Slaleof FloridaCOmmi'sion
# GG 084621
Comm Expires Mar 20,2021
dedlhraugh1`181 al NoAssn,