HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: -\\aa&A Permit Number:
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Building Permit Applicati n FEB a
9 P " 3 Luc.j
Planning and Development 1
Building and Code Regulation Division 'ST Lucie Count
2300 Virginia Avenue, Fort Pierce FL 34982 y' Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:New Construction
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Property Tax ID #: I`3- �1 r 1 b(—C) 544 - 0 co-'t'J Lot No. IZ�
Site Plan Name:- �PisS �' 1�YY1P`(� p( Block No.
Project Name: � FL I /1
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Additional work to be performed under this permit— check all that apply:
X Mechanical_/ Gas Tank'-° " t _Gas Piping _Shutters Windows/Doors,
y` Electric Plumbing — Sprinklers _ Generator A Roof Pitch
Total Sq. Ft of Construction: 2Y Sq. Ft. of First Floor: IS/ 20
Cost of Construction: $ Zq - n%d U Utilities: X 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: — 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 N0772-905-8394
Fill in fee simple Title Holder on next page ( if different E-Maid Pslpermits@adamshbmes.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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MORTGAGE COMPANY:
Name:
�{i'C9hTESr;y _ G^r6 .�J�
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_ Not Applicable
DESIGNER/ENGINEER: _ Not Applicable
Name: Keesee Associates
Address: 945 South Orange Blossom Trail
Address:
City: Apopka
Zip: 32703 Ph One407-880-2333
State: FIL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Amehdments.
The following building permit applications are exempt from undergoing a full concur'rency 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."
ture of Owner/ Lessee/Contractor as Agent for'Owner
STATE OF FLORIDA
COUNTY OF SainlLucie
The forgoing instrume t was acknowledged before me
this day of r Cj' 20�Zj by
Name of p rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K Pl DWI h
(Signature of Notary Public -State of Florida )
Commission No. a,7D�
��� No
Wry PuDhcst
SOeta
Hannah E Moore
M mmi
)0, w Expues 07i01202
REVIEWS FRONT ZOkia
COUNTER REVIEW
RECEIVED
DATE
COMPLETED
ature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF SaintLucle
The forgoing instrum_en was acknowledged efore me
this day of t� 20 by
�Yy an a A
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Y h OW IDS
J Y UUL WOU
(Signature of Notary Public- State of Florida )
in No. l . (Seal)
Rde VEGETATION
REVIEW REVIEW REVIEW