HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
P.hone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X:
PERMIT TYPE: New Construction .: .
I?R00QSED1 IMPROVEMENT LOCAT,I�OnN v "t
Address:
Property Tax ID #: 1311' �� I ' �wD� ' V I Lot No, �—
Site Plan Name: +_ .� S Ito hi t Block �5
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Project Name: f"T i -� W ,�ts �''` (� 1� (�(i� i 11�
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DETAILED DESCRIPTION O:F WORK
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank ' Gas Piping _ Shutters- -windows/Doors
Electric Plumbing _r5p'rinklers Generator Roof Pitch
_
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —o
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Cost of Construction: $ 2y I 9 O 0 -Utilities: ZCSewer _Septic Building Height:
WNE,f2/LESSEE
CONTRACTOR
Name Adams Homes of Northwest Florida, Inc.
Name:william Bryan Adams
Addres:3000 Gulf Breeze Parkway
Company: Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze State: _
Address:3000 Gulf -Breeze Parkway
City: Gulf Breeze State. FL
Zip,Code `,32563 Fax:
Phone No. '�2-905-8394
Zip Code: 32.563 Fax: 772-905-8511
E-Mail:Pslper�its@adamshomes.com
Phone No7,72-905-8394
Fill in fee simpl&-Title Holder on next page ( if different
E-Mail psipermits@adamshomes.com
from the Owner Ii ted 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, 0 .K more, a RECORDED Notice of Commencement is required.
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-DESIGNER/ENGINEER: _ Not Applicable
N a m e: Keesee Associates
Address: 945 South Orange Blossom Trail
City: Apopka State: FL
Zip: 32703 P h o n e 407-880-2333
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 of 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;' ib 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; screen rooms 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 INTENDTO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER•OR AN ATTORNEY BEFORE RECORDING YOU OF, COMMENCEMENT."
Signature f--G erf Lessee/Contractor as Agent for Owner
Signature of Con r;a or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this Ldayof N10V 20�by
this day of �iov 202l�by
5Y\1 G M f C-dG yy(S
YN CA )�j � Ck ME
Name of person making stateoeret....
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 liic- Stoat o Florida)
(Signature'of Notary Pub(lli tate o FI rida )
Commission No. O u 0 I (5e�)�';,,;,.,
No.
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DATE
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DATE
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Florida
2021