HomeMy WebLinkAboutBuilding Permit Application.. r-
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �a�$ 1Za Permit Number:
� 1J D
EC 0 $ .,;'�
• Clion
Building Permit ApplicaPlanning
and Development Services ie County, Permitting
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 -' S V-
NWT "��-M' f
PR 1 P®SEfDSIMPR PdUE?IUIE'NT=LOCATI N g$' �r x� � d
n.wa a..4aa:..b.Y..dk....A,-.r.i.,..�_rt r1„ !S v ..,. _.'�.4i.'•.SY,�s'•.r�"-..."5 n'Pr..'ttr
S
Address:
Property Tax ID #: S 0 - O O O � � Lot No.
p3
Site Plan Name: U .0 Block No. )
Project Name: Iff Ho rfltf cI i K t irth
�.'�5`� -.ytp�.,t'�'+�. '� .0 +,d?�i`:'� 4.'Y" fE1�� � 5 r�!"4 K`�.LT�iG Y� � 1J' ��`��• , ht... +• }�� +r". b'"i
Y7ifysYP {2 $S�V ,+J 1i19c��hsx�s�{°�„,$'W th' GG4'S " a
-,x ".? $ 2. fir' 3rYXaSj If'r6 'Yya: S�^
�A
Additional work to be performed under this permit —check all that apply:
Mechanical as an �I Gas Piping Shutters" Windows/Doors
_
Electric Plumbing , _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: I O Sq. Fit. First Floor: I �,
of
Cost of Construction: $ Utilities: Sewer Septic
I _ Building Height:
,'rAvrr�{q��W'v`4+4:-rWY 4ca�'+ms�aran �( r ",u" B ti „Y-' ar �• r
4 ! ;t r %n b... ,� +' i , - Y•. ' v aAm. ,',F 1 5 .[r - .:� ,•ei'Fv •,'zca+U ayu73.7�ttar: ;: ;'apt a 4 a or`'p'. 'rf"" 'To x = 'P,, �
air. , , + i t t UA ,+�}x,:
CO,NTRAT®JR� ,,•aY
MINN.:
.:,, _ sr v , h a _ � }`s:k
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 $7,500 or more, a RECORDED Notice of Commencement is required.
*0
-'N' T-. ^� , N ' '.$4'(, ni a
SU L M,ENTA� GONSTRUCI,.ON I�EN IN
.s?'�M&r` T,t''�,.. -' '�.a'`Y�`� :G r r• .ud'. tN'..'!•<ti sue` x'". V 'rRzBF . ..
ORMAI'IONn� �t
CLAW
�
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Keesee Associates
Name:
Address: 945 south Orange Blossom Trail
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 covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review,your deed for any restrictions which,maj 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 a.nd St. Lucie County.Amendments. '
The following building permit applications are exempt from•undergoing a full concurrency reyie`w: room additions, r
accessory structures, swimming,pools, fences, walls, signs, sereen 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. INTEND TO OBTAIN FINANCING, CONSULT'
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." i
-Lessee/Contractor for Owner
Signature Con Holder
Signature - as Agent
of ra or/License
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF salntt.ucie
COUNTY OF saintLuoie
The fQ�going instrument was acknowledged before me
The f r oing instru nt was acknowledge before me
this `i day of Dc C" 20U by
this day of 20-U by
5r\1G M -I da Y_Y� S -
F)ry a tj ICI ct M9
Name erson making statement.
Name ot person making statement..
Personally Known x OR Produced Identification
Personally Known .x O'R'Prod'uced Identification
Type of Identification
Type of Identification
Produced
ZXAMJ ea� 'ARQ�a��
Produced
upl" 2.4gg
(Signature of Notary P lic- Stat o Florida)
(Signature of Notary Publi tate o FI rida )
Commission No. �i O u u I (Sella;,,;
No. 6
. RiCHARDOOUG
cJOmmo ssi I
A'<" No!ary? rric-
}
,iateofFlorida """ RICHARDDOUG
+lY F
�, r�.'•-Nntm
_• /'•�'D - Coinm:s:;ioriN
G084821 =t; Publin _S
'•.°�o;
i y l omm. cxpi
I N
es ar ,
lional '
_' '
n = Commission
C� a •
REVIEWS
FRONT
ZONIII
r
VEGETATION
,�. +i
SEA TUR fry��
x it
fNd�tOVEf p
COUNTER
REVIE
REVIEW
REVIEW REVIEW
REVIE
+ ; houohNa
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
Florida
20, 2021