HomeMy WebLinkAboutBuilding Permit Applicationi
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED pp���
Date: Permit Number: W�
RECEIVED
Building Permit Applic ition NOV 24 2020
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 e,�eCounty, FL
Phone: (772) 462-1.553 Fax: (772) 462-1578 Commercial R
PERMIT TYPE: New Construction
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Address: MN 1 AO 0
Property Tax ID #: _1 3' 1' 1 0 0- 5 D p O ', Lot No. 11
Site Plan Name: Mums �-H b m—x S Block. No.
Project Name: � a{ i s ti VY n pi N 0 VIVI NJ si i I DO 1 CACA N
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Additional work to be performed under this permit — check all that apply:
V Mechanical _Gas Tank _Gas Piping _ Shutters %t.'Wiridows/Doors
I` Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 2l.¢ 09 Sq. Ft. of First Floor: 1�Z0
Cost of Construction: $ 2g�, �� p Utilities: Z( 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 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
f value of construction is $2500 or more a RECORDED N f
, once o Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SPLE==�M�ENTA��Cy N�TR<UgY�t���hN.{,�N{f=V11
MORTGAGE COMPANY:
Name:
Address:`
-
= N'ofApplicable
DESIGNER/ENGINEER:- . _ Not Applicable
Name: KeeseeAssociates...
Address: 9458outhOrangeBlosso'mTrail..` :
'City:, Apopka' State: FL
Zip: 32703 Phone 407-880-2333
City: -
Zip:
Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:' '
City: "
BONDING COMPANY:
Name:
Not Applicable
Address:
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 mey"restrict& prohibit such
structure. Please consult with your Home Owners Association and review your deed for any r,`estrict(ons'i&ch,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; vvalls, signs; screen rooms.arid accessoryu5es to-* pother 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 ATrORNEY''BEFORE .RECORDING YOUR NOTICE' OF COMMENCEMENT "
Holder
Signature f—ow rer/ Lessee/Contractor as Agent for Owner
Signature of Con ra or/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF saintwcie
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this r e day of NOy 20� by
this AU day of N cif 202Q by
�I G r�J d G YY1 S
l rA CA 1tSi) 'TATcl C1 ME
��JY
Name ot person making statement;
Name o 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 Publlli tate o1 FI rida )
O I
Commission No. D (Se lf';„-. Ri:,IARDDOUG
�JOMMS ssi No. 6LS
<5 : Notary Puill -,
..
i21e of Florida RICHARD DOUG
rh5' a • `: Ca nnssion
A GG 084821
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DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19
Florida
is N jr 20, 2021