HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11.45- OR 091) Permit Number:Cal alb to
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: New Construction
Address: SU O2'K,K'j)
Property Tax ID #:
Site Plan Name: ,�/� C o
fful nVProject Name:HI I 1 I f J � f
Commercial Residential X
Lot No. 2 0
Block No.
I NC.
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank' _ Gas'Piping _ ShuttersWindows/Doors
Electric Plumbing Sprinklers _ Generator 1K Roof Pitch
Total Sq. Ft of Construction: qZ� c�11 Sq. Ft. of First Floor: Z I 1 5
2 0
Cost of Construction: $ 1 I Utilities: —Sewer Septic Building Height:
Name Adams. Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: _
Zip Code: 32563 Fax:
Phone No. 772-905-8394
E-Mail: Pslpermits@adamshomes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: William Bryan Adams
Company: Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze . State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone N0772-905-8394
E-Mail Psipermits@adamshomes.com
State or County License CRC1330146
11 vul— U1 �W114%1 uLuun is ,,cjuu ur more, a KMUKutu Notice of commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
�?+,�?f4,� Cdait'r:�2 ��,�r3�d +�'�a, a�.�" a;:71,Y;.fa�l�'sY'. .�r'S� t. n,3a'a P :r-i,ui�;,iiYSa�
7F�; �Kj� F�;�iye� N ��;�P ,r�z}'• ��`" � i-'€
W
DESIGNER/ENGINEER: _ Not Applicable
Name: KeeseeAssociares
MORTGAGE COMPANY: Not Applicable
Name:
Address: 945 South orange Biossom Trail
Address:
City: Apopka State: FL
Zip: 32703 P h o n e 407-880-2333
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 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 concurren'cy.revil room additions,
accessory structures, swimming pools, fences, walls, signs,,screen.rooms-and accessory.usl anothernoh-.: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 BEFOREv RECORDING YOUR NOTICE,6F COMMENCEMENT." -
Signature f Ovatter/ Lessee/Contractor as Agent for Owner
Signature of Con ra or/License. Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saintt.uoie
COUNTY OF saintLucie
The fo ling instrument w s acknowledgedbefore me
Z �by
The fo ing instru ent was acknowledge efore me
L
this day of ��, 20
this day of 20_ by
b�v G t� Ada S
Iry c� Ct MS
Name— o person maKi,ng; 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 Iic- Statkol Florida)
(Signature of Notary Publi tate o FI rida )
Commission No. O� D I ($e1(�',';
No.
. RiC,iARDD000
�JOmfO�Issi
Notary P:aiic -,
tate of Florida RICHARQ DOUG
• . a • _ Co.n.nssior.
nim. xp,
,
asMar ,y
_.
; Commission
REVIEWS
FRONT
ZONI
r' i , N
tiona' r VEGETATION
SEA TUR E.,
NC OVEE1 it
COUNTER
REVIE
REVIEW
REVIEW REVIEW
REVIE
through Na
DATE
RECEIVED
DATE
COMPLETED
Rev.)-/7/19
Florida
2021
Assn.