HomeMy WebLinkAboutBuilding Permit Application--1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q�` a -I lad Permit Number:
- - Building Permit Applic tion
Planning and Development Services C T 2 7 L0213
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Rilal—X�
PERMIT TYPE: New Construction - 5
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Address: % 1'I I M ,P j/ U y0 '�} �J �Q
Property Tax ID #: 131 1• 1 Q 0- Q U 119. 0 Q 0• � Lot No. c3 O
Site Plan Name: AdUMs M rn g f Block. No. (
Project Name: dC� iM S .e s 0f IN o f th W s t F-1 p Y i a q r N
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Additional work to be performed under this permit —check all that apply:
v�Mechanical _ Gas Tank _ Gas -Piping _ Shutters Windows/Doors
I` Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 25 $ U Sq. Ft. of First Floor: ) 7
Cost of Construction: $ Z 13, 3 S 0 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 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 $1,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _
Name: Keesee Associates
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 945 South Orange Blossom Trait
City: Apopka
Zip: 32703 Ph one407.880-2333
State: FL
Address:
City:
Zip: 'Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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.covenaInts that may•irestrict or prdhibit 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.l will; in all respects,,perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
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The following building permit applications are exempt from undergoing a full concurrency review: room additions,"
accessory structures,swimming pools,,fenc.6, walls, signs, screen roomstand•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."
Signature f-A3wniL-r/-Lessee/Contractor as Agent for Owner Signature of Con ra t-or/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucle
STATE OF FLORIDA
COUNTY OF SaintLucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this jR_ day of 0C '1• 1202 0 by this _A day of b G 't' , 20-7-0by
5Y � G Y\J -Rd CA YNA S 1) YN C VQ TACA' Ct M S
Name ot person making statement. Name�n making.statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary P lic-StCa/t of Florida )
Commission No. O D I (Ss jj;,,;- RIC,HARDD000l
Notary
• . „;,,; at' Coo!m.ssionk
REVIEWS I FRONT ZONI
COUNTER REVII
DATE
RECEIVED
Personally Known x OR Produced Identification
Type of Identification
Produced
Lek" 2MJ4QLA
(Signature of Notary Pub(lli tate o FI rida )
, afflSpNssi No. b
!teof Florida d: ;a ';;; RICHARD D01.
eOMPLETED I 0 ®G
' v' • = Commission
�lry VEGETATION SEA TUR ;�" 1 `,NGIkOVEExP
REVIEW REVIEV%__' Ituouyht'
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Florida
20, 2021