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HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date: , �• IQ Permit Number:­---4-2 V. r�:•. V L^'.� x{Yy �. • • • _ OCT 0 G Z920 4s' - Building Permit Appli ation . r�rn ent ry Planning and Developrhent Services perr a4ttP•4t s` ; Building t.uu"'tN/F FL and Code Regulation Division St• LUC4e 2300 Virginia Avenue, Fort Pierce FL 34982 --� —`- Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT TYPE: New Construction 6�P OAP®SED 111/I�PR,+� VE�IVI E�NT�LO A It$?ZN,� 3. INK�� Address: �j300 1 1 YYI G Ih M Y Property Tax ID #: I3 I I" 1 0 0• 0 l 2 3" 0 0 0- S Lot No.�l Site Plan Name: Oda m S t �) m e S Block No. 2 `,.' _ ! � Project Name: 0 S 1 1Q MX S Qk tA0VTh Yy ks i r' C I 1\J c, l p�`,�ar�-T�� ' s��.�,�� r�? �� r��„� ��� ..J�`s'� •� �� { .2�';?�gcr��'��'-�`� - F• "" t t�?' ; :.a, J �",�k � Q:r�,�<sTM,.�„tia �ii.�;r�'r'«�a4:��£ �.�:$ws+�i�':H'i D:���., 0.�i��'n d;r fit_ F ,xi'-.'iy..«-c '..r.Et''z«,��n"•'c,w°�+kf�s �r��YtS«���F" ':JFik"u�''Z.����+��uM�i� fe `ki. },�:��hl�!..ty j.. T. 3bk1fFQ.'J�'tf,p-a,;y�"yyP �."y, v� ..�w�,.,.. . �,�4,� �,,. �pIlq,.gK k ti.;'G.s �.... t;r„i •.�,r J � ..G..11� sr:.'^/'rpiJ,�`.tSl'I 'l4ITI. v!h'{.-1Ci sS:. 1. � t�4 -� , t�f^+ �N.�Y"Sc7'Q�v � 'C. W 't € f1 . 2A �F •4' N •Ir''.i K-. CONS�TR:UC�TI.� �, .„ C i ; ;r ,.�-'f�`'��: ���' ?a { ,.kit • Y''�I,i<a.'•,c ���''.'��`'�=,�?s �,f��"� �'Y�t ? �=-,�n � ,�,:�'�ctr�.'� ;r:�`�'.d I��,kk,•�������� ���,�N,uINF�O,�RMA�TION:�,,���� ��£Ji; ��`.d� � [4�'��'��._ y� .via ���'�,���(�rta��t(�.��y�� �«,,f ���, Additional work to be performed under this permit- check all that apply: Mechanical ­ • ' _ Gas Tank • _ Gas Piping —Shutters /� Windows/Doors �/ 1` Electric -1 Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: 3119 Sq. Ft. of First Floor: 22 R 1 Cost of Construction: $ 31W , Cl Db Utilities: !C Sewer _ Septic Building Height: "trrvr" Tt4srra•,='.ro' ,,..M�sm w3'ys •�.x:�t" pp�thr3i�tYv..t "rr'fM.�,'�'� fb"7 `r', `�=•'F`` ;•:� 'i F - L. "7fv,z�iv y;`AY,f,'''7sn(p:JnN'€yiir%:s!`/rr:aR:d.'i+t-'tiys.n /F rFJ�'Y IY- l riW r TO,R� 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 No772-905-8394 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. � 5Sa • l gtv%Ak' WS;UPPLEMI�AL CENSTft;UCTION��IgE�I 'N' `tr'`�i,�f.n .a�d6 .�k.�A''�"`�e.:'�e.�d��� '_'Y.,'X,e� ' d+ '§`"'4Y" }; -7au.��u.��'_»'��Hr'.t=Hi�'�"�5�'�""'•�. s;r ri�cFc'R / 'M'k i'" i%,+•' , 4f..'w""w, r�`�.�i'.,.s ��.#,�. a';��,��+y�e st u�'�u� ���tF DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Keesee Associates Name: Address: Address: 945 South Orange Blossom Trail City: State: City: Apopka State: FL Zip: 32703 Phone407-880-2333 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: 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; screemrooms and accessory uses td 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 f©wrter/ Lessee/Contractor as Agent for Owner Signature of STATE OF FLORIDA COUNTY OF Saint Lucie The forg oing instr Spent was acknowledged before me this 'Z Lday of t. 2010 by STATE OF FLORIDA COUNTY OF Saint Lucie /License Holder The forgoing instrument was acknowledged before me this `LZ.day of SR.P't 201--0 by ,LUGy G i\J -tdG Y-n S ?)YN Q L"J TTILA G ME Name ot person making statement. Name�n 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 ) Commission No. O D I (Se if nt yA o r Nolilr'yP�hRC— • who' or • = Commission REVIEWS I FRONT ZONI COUNTER REVII DATE RECEIVED DATE COMPLETED (Signature of Notary Pub(lli tate o FI rida ) camsplussi No. 6 teof Florida , '; RICHARD DOUG A OHNSON GD04fi21 — tal fFlorida ar Commission G 04821 a' r VEGETATION SEATUR 1r"y��.� NCt�9MEExpir s r20,202t REVIEW REVIEW REVIE mroughtJafon olayAssn.