HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: �—rJJ o Permit Number: Z� t -D, 3
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 #:
Site Plan Name: _
Project Name:
Additional work to be performed under this permit —check all that apply:
X Mechanical Gas Tank _ Gas Piping _ Shutters
y` Electric /� Plumbing �Sp k rs _ Generator
Total Sq. Ft of Construction: b % Sq. Ft. of First Floor: _
Cost of Construction: $ oC �7P q 00 Utilities: Sewer _ Septic Building Height,
Lot No. �Z
Block No. J
Windows/Doors
X Roof . Pitch
113z(25
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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
IT Value OT construcxion Is :�LSUU or more, a KECUKDED Notice 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: Applicable
Name: i<eeseeAssociates
_Not
Name:
Address: g45SouthOrangeBlossomTrail
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 o,r 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'respeets, 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 addition's,
accessory structures, swimming pools,`fences, walls, sighs; st'reen-roomsand accessory uses to anothe'r non-res;idential 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 OMEMENT "F a
Signature of Owner/ Lessee/Contractor a?gent foil Owher
STATE OF FLORIDA
COUNTY OF Saintt.ucie
The fo�go�g instr ment was acknowledged before me
this 4S day of 0001 VA� 20'Z) by
Name of p&son making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K n m In
(Signature of Notary Public- State of Florida )
Commission No. ���
f.?LS�"
Notary PuWtc Saab
Hannah E Moore
REVIEWS FRONT ZO
COUNTER REVIEW REVIEW
RECEIVED
COMPLETED
Signature of Contractor/License Ho
STATE OF FLORIDA
COUNTY OF SaintLuofe
The forgoing instr ent was acknowledged before me
thisday of mu( ''nnnn20 - by
vi.
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Y-h OW I'S
:�a kUL MOAJ_
(Signature of Notary Public- State of Florida )
n No. —t I (Seal)
VEGETATION
REVIEW REVIEW