HomeMy WebLinkAboutBuilding Permit Applicationt i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED hh
Date: Permit Number: 2t U Z' V 32S"
R,, C RECEIVED
COUNT 0 PL T V AFEB 11 2021
Bu.ilding Permit Application Permitting Department
Planning and Development Services St. Lucie County
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:
-Ono-
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters� Windows/Doors
Y` Electric Plumbing ��' _Sp.rinklers _ Generator X Roof Pitch
Total Sq. Ft of Construction: /L Sq. Ft. of First Floor:
Cost of Construction: $ oZ-7 5 0 U Utilities: t 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
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone N0772-905-8394
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 LIC uLPINILI uLLwn acauu ur more, a nrLuKutu ivotice oT 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
aaYL.';'�vki�?I?
MORTGAGE COMPANY: Applicable
Name : I(eesee Aseodates
_Not
Name
Address: s4sso�mo�an9eeios5omrra�i
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.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 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."
ature of Owner/ Lessee/Contractor as A ent for.Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF SafntLude COUNTY OF SafntLude
The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this � day of3CLhLL0Lr4 _, 20�( by this day of 201,J by
a Yl Hd rn f
Name of p rson making statement. Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced KY1ON V)
(Signature of Notary Public- State of Florida )
Commission No. O.D9ikodr!�J�S'�Hoa�nnahl
tary Pic SO�b
Moore
REVIEWS CO ONTER I REVIEW I REPVIEW
RECEIVED
COMPLETED
Personally Known x OR Produced Identification
Type of Identification
Produced Y. VnW IDS
J a UUJ ftUOAJ
(Signature of Notary Public- State of Florida )
n No. —1 1 (Seal)
oQhAQ6,S I VEGETATION
REVIEW REVIEW