HomeMy WebLinkAboutBuilding Permit Application-AII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO.BE ACCEPTED
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Date: Permit Number:
Planning and Development Services
Building acid 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
.PROPOSED IMPzF'OV.EMENT LOCATION
Address:
Property Tax ID #:
Site Plan Name:.,
Project Name:
CO"ONNTRUMCFO Ag
Additional work to be performed under this permit — check all that apply:
X Mechanical_/ Gas Tank _ Gas Piping _ Shutters �/ Windows/Doors
y` Electric �n Plumbing _-Sprinklers _ Generator /� Roof Pitch.
Total Sq. Ft of Construction: -2—Lo -- Sq. Ft. of First Floor: /D 7-0
Cost of Construction: $ P.7 Z ` CO Utilities: Y Sewer _ Septic Building Height:
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OV1/RWLESSEE
tCONTRACTOR
Name Adams Homes of Northwest Florida, Inc. '
Name:William Bryan Adams
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze ; . State: _.,
Zip Code: 32563 Fax:
Phone No:772=905-8394 :', ..
Company: Adams Homes of Northwest Florida, Inc.
Address:3000;Gulf.,Breeze Parkway•
City:' Gulf'Breez! � :; State: FL
Zip'Code?` 32563: - .: d '. Fax: 772-905-8511
;Phone No772-905=8394'-
E-Mail:psip'brrmits@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
IIf 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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SUPPLEMENTAL CONSTRUCTION
5, i. £
LIENx LAIN INFORMATION
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i.'°*,. `i:,
DESIGNER/ENGINEER: _
Name: Keesee Associates
Address: 945 South Orange Blossom Trail
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City: Apopka
Zip: 32703 P h o n e 407-880-2333
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
Zip: Phone:
Address:
City:
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."
ure of OWx4eTJ Lessee/Contractor as Age
STATE OF FLORIDA
COUNTY OF Salntt.uoie
The forgoing instrument was acknowledged before me
this IL day of PeJorua-v'Li 202K. by
Name of p rson making statement..
Personally Known x OR Produced Identification
Type of Identification
Produced K 1 M V1
re of Notary Public- State of Florida
Commission No.
�.�` Notary PuDhc Sons
Hannah E Moore
o,a Expuea W/01202
REVIEWS
RECEIVED
DATE
COMPLETED
Signature -of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The for oing instrument was acknowledged before me
this y day of c ru_O_C 202- by
1+��ry a n "nor
.s
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Y nbW I�,&
(Signature of Notary Public- State of Florida )
No. 'l 1 (Seal)
COUNTER REVIEW REVIEW I REVIEEW� VEGETATIONEV EW.