HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
on
Date: Permit Number:
. 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 Commercial Residential X
PERMIT TYPE: New Construction
Property Tax ID #:yy��Ii) I' •, O I • � �' - O b Q • b Lot No.�_.
Site Plan Name: Tf�q S 0 m f Block No.
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Project Name: O m J d o r t h w .lfcoadul INC
M Oct 011
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Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _Gas Piping Windo'ws/Doors
_Shutters.'
Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: __, Sq. Ft. First Floor:
CA of
Cost of Construction: $ 2 5 b , 400 Utilities: � Sewer _Septic Building Height:
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 N0772-905-8394
Fill in fee simple Title Holder on next page ( if different E-Mail PSIpermits@adamshomes.com
from the Owner listed above) State or County License CRC1330146
If value of construction is $2500 or more a RECORDED N :
ce of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: KeeseeAssociares
Name:
Ad d re s s : 945 South Orange Blossom Tram
Address:
City: Apopka
State: FL
City:
State:
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 coven ts•that may, restrict or_prohibit such
structure. Please consult with your Home Owners Association and'review your deed for ariy �estrictio6s whichrmay 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, swimmirig pools, fences, walls, signs; screen rooms and accessory.u'ses to another.non presidential 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:" '
Con Holder
Signature f-owger/-Lessee/Contractor as Agent for Owner
Signature of ra for/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF Saintl_uoie
The forgoing instrument wa� acknowledged before me
`
The forgoing instrument was acknowledged before me
Z:()by
this day of N J 20n by
this _LL) day of N Obi 20
a �I G ICJ -Rd G YY� s _ _ __
Fry CA -) � G M S
Name o person making 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
Ry-�
Produced
(Signature of Notary P lic- StCa%t o Florida)
(Signature of Notary Publlli tate o FI rida )
Not t I
No. 6
Commission No. 0 (Se j�;;,;•.,, KiC„1ARD000G
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DATE
RECEIVED
DATE
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Rev.
Florida
�s Nlr 20, 2021