HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLE I ED FOR APPLICATION TO BE ACCEPTEDf�`
Date: Permit Number: Z/ 63 IYY_
C690
7.
Building Permit Application yE
Planning and DevOoipmen t Services '� d
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 .
Phone: (772) 462-1553 Fax: (772) 462 5,78 Commercial Residential X
PERMITTYPE: New Construction
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Address: 2 Ll Pt �
Property Tax ID #: �3 ' %�� "�j`3 ��0 y Lot No. 2-7
Site Plan Name:, "WeLry-s 16mo s �,
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Project Name: ��QMC,-' aar"C--S IvoC ��W -� 1rlCl�mc� C
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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 Plumbing _ Sprinklers _ Generator Roof . Pitch
Total Sq. Ft of Construction: 31 � Sq. Ft. of First Floor: 2 Z 7 7
Cost of Construction: $ 3ZbTg6b Utilities: XSewer _ Septic Building Height:
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: _ Address:3000 Gulf Breeze Parkway
Zip Code: 32563 Fax: City: Gulf Breeze State: FL
Phone No. 772-905-8394 Zip Code; 32563 Fax: 772-905-8511
E-Mail: pslpermits@adamshomes.com Phone No772-905-8394 .
Fill in fee simple Title Holder on next page ( if different E-Mail psipermits@adamshomes.com
from the Owner listed above) 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 $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER. _Not Applicable-
MORTGAGE COMPANY: Applicable
Name ; Keesee Associates
_Not
Name:
Addres$: 945 South Orange BlossomTreil
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, perfo'rm'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, swimmingpoolsJences, walls, signs,screen rooms and accessory uses to another non•re'sidential 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 iment was acknowledged before me
this day of li&CP' 20U by
Name of person making statement:
Personally Known x OR Produced Identification
Type of Identification
Produced K n M V
hut W lY J
(Signature of Notary Public- State of Florida )
Commission No.�
Tj7p_JA Notary P.t*. SLeti
Hannah 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 of4-,''nnnn20� by
It � /.I' f
Name of person making statement -
Personally Known x OR Produced Identification
Type of Identification '
Produced Y—h OW NS
(Signature of Notary Public- State of Florida )
n No. —1 ! (Seal)
VEGETATION
REVIEW REVIEW