HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Zl Dy
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: - G 3 0-
Building Permit ApplicattAp zo?1
St 4Uc e c Upt,
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Commercial Residential' X
PERMIT TYPE: New Construction
Address: _ O_sl�b_ttkn ibe
Property Tax ID #t: 13
Site Plan Name:
Project Name: �ia dV1C ,n
Additional work to be performed under this permit- check all that apply:
X Mechanical Gas Tank _Gas Piping _ Shutters
X Electric Plumbing _ Sprinklers — Generator
Total Sq. Ft of Construction: _2 ,�
Sq. Ft. of First Floor:
Cost of Construction: $ 2y�2�b
Utilities: Sewer _ Septic
Name Adams Homes of Northwest Florida, Inca
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze
State: _
Zip Code: 32563 Fax:
Phone No.772-905-8394
E-Mail: Pslpermits@adamshomes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No. ! l
Block No.
„P
�/ Windows/Doors
/� Roof Pitch
1�IZ
Building Height:
Name: William Bryan Adams
Company: Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze FL
State:_
Zip Code: 32563: Fax: 772-905-8511
Phone No 772-905-8394
E-Mail pslpermits@adamshomes.com
State or County License CRC1330146
If value of construction is $2500 or more, a RECORDED 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:
_ Not Applicable
Name: Keesee Associates
Name:
Address: 945 South Orange Blossom Trail
Address:
City: Apopka State: FL
City:
State:
Zip: 32703 Ph o n e 407-880-2333
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 authohze.the permit holder to build the subject"str.ucture
which is in conflict with any applicable Home Owners Association rules, bylaws or a.nd,covenants that may restrict.or prohibit such
structure. Please consult with your Home Owners Association 9nd'review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, hereby'agreehhat 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 ;RECO�RDINC YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contriactor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
STATE OF FLORIDA
COUNTY OF sainlLucie
The foIrgoing instrutnent was acknowledged before me The for oing instrulnent was acknowledged before me
this day of J a F. I a t% ell A 20� by this day of 1nn20v by
N Won RdadL
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Name of p rson making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced KN OW n Produced 1(h OW IDS
(Signature of Notary Public -State of Florida )
Commission No.��
REVIEWS FRONT ZORIIM
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
J
MOAJ
(signature of Notary Public- State of Florida )
1ros omm s n No. —1 (Seal)
Notary Puft SOot+� oormja
m
Hannah E Moore
gjkc��QapK,,� I VEGETATION
REVIEW I REVIEW REVIEW