HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: y `'� 2 Permit Number: C '� ' Z / / 0
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
Address:
Property Tax ID #: 1311 _' :7 0' — (')ON r p00 77 Lot No.C-:;L]_
Site Plan Name: `m II'11 -- A- (n� f �( Block No.
Project Name: �j IT Me__J_� C VV VVP S t ,rl C� i A) r .
Additional work to be performed under this permit— check all that apply:
%*, Mechanical _J Gas Tank _ Gas Piping _ Shutters' Windows/Doors
y` Electric Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 94 09 Sq. Ft. of First Floor: _ 1 S Zn
Cost of Construction: $ o �800 Utilities: YL Sewer _ Septic Building Height:
£OWNER/LESS:EE
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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: _
Zip Code: 32563 Fax:
Phone No. 772-905-8394
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone No772-905-8394
E-Mail: pslpermits@adamshomes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Pslpermits@adamshomes.com
State or County License CRC1330146
VO UC Uwnau uuiun is ,?cauu or more, a KrwKuru Notice or 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
Name: KeeseeAssociates
MORTGAGE COMPANY: _Not
Name:
Applicable
Add re$$: 945 South Orange Blossom Trall
Address:
City: Apopka State: FL
Zip: 32703 Phone407-880-2333
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not
Name:
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 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, iri 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor fil Agent ibr Owner
STATE OF FLORIDA
COUNTY OF SalntLucie
The forgoing instru ent was acknowledged before me
this22day of _�jG6r\LLa_V'4 20 2( by
Name of p rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced k n M h
of Notary Public- State of Florida )
Commission No. _1D9
REVIEWS FRONT Z01r4'IaM
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
re of Contractor/License Hold
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this27- day ofrr'J41' ULD ''n 220� by
l�M40 W f
Name of person making,statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K h OW I'S
:�a kUL AUOAJ —
0
(Signature of Notary Public -State of Florida )
NolaryP'bhcSOsb s n No.
Hannah E MOore
M m t
Expires 07i01202 Alp
RII VEGETATION
REVIEW REVIEW REVIEW
(Seal)
expires