HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q I,
Date: d� 1 �' Permit Number:OPM- 17
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" RECEIVED
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Building Permit Applicatio i. FEB 12 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: New Construction
Address:
Property Tax I D #:
Site Plan Name:
Project Name:
---7(�1- nd--7--ovo
Lot No. 00
Block No, _
Additional work to be performed under this permit— check all that apply:
X Mechanical_/ Gas Tank _ Gas Piping _ Shutters �/� Windows/Doors
X Electric !� Plumbing _Sprinklers _ Generator /� Roof Pitch
Total Sq. Ft of Construction: o-1 Sq. Ft. of First Floor:
Cost of Construction: $lam _ D6 Utilities: 4 Sewer _ Septic Building Height:
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�CONrnTRACTQR . X111
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
VaiUc u! wnsuULtiun is acouu or more, a KtwKUI:U 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
Name : I(eeaee Assodates
MORTGAGE COMPANY: � -� Not Applicable
Name
Address: 94e so��n ora�9e sio55om roan
Address:
'City: -Apopka State: FL
Zip: 32703 Phone407-880-2333
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:.
BONDING COMPANY: Not Applicable
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 may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1,vuill, in all respects,"perfprm-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.nbn'-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." `
ture of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF saintLuole
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of p rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K,n M i)
(Signature of Notary Public- State of Florida )
Commission No. OrlV-1
T?LS�"""HatnnahNoary E MSdb E Moore
REVIEWS FRONT ZO
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this day of . 20_ by
Nan ftflawf
Name of person making statement.
Personally Known x . OR Produced Identification
Type of Identification
Produced K Yl OW IDS
�aChu WOU
(Signature of Notary Public- State of Florida )
No. q ! (Seal)
Bapl VEGETATION
REVIEW REVIEW