HomeMy WebLinkAboutBuilding Permit Applicationr�
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Ali APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED,
Date: � ��� Permit Numbera% % ®�
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
Lot No.J7
Block No. Z
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Additional work to be performed under this permit — check all that apply:
X Mechanical Gas Tank _ Gas Piping _ Shutters` Windows/Doors
X Electric n Plumbing _ Sprinklers _ Generator X Roof Pitch
Total Sq. Ft of Construction:
%c3 Lid 6 Sq. Ft. of First Floor: yZ15'Z.3
Cost of Construction: $ l , QI:) Utilities: Sewer _ Septic Building Height,
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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
Add ress: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 or construction is ,ILSUU or more, a KtLUKUW Notice ot Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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�S PrP;LEMEIVTA�.L CON>STR•I�J�CTiO�N+LIE I�AW IN�F.OR�MA�TI�O:
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DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY:
_Not Applicable
Name: KeeseeAssociales
Name:
Add ress: 945 sou�i, orange aics5om Traii
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. covehants 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, 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 coricurrency review: Boom.additions,
accessory structures, swimming pools, fencespwalls; 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 as Agent `For Owner
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instr ment was acknowledged before me
this fi day of A 201L by
� buo 0— No M
Name of p rson making.statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K,nONi)
(Signature of Notary Public- State of Florida )
Commission No.
��� Notary Public Sn1r
. Hannah E Moore
• M m
`o,,, E><pnes O7rOt2o2
REVIEWS I FRONT ZORM"
COUNTER I REVIEW
DATE
RECEIVED
COMPLETED
of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The for oing instry�ment was acknowledged before me
this day of P202,A by
l� /.►' f
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced _ h O W I'll&
ih UUL MOU
(Signature of Notary Public- State of Florida )
No. l 1 (Seal)
VEGETATION
REVIEW REVIEW REVIEW