HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date d+3 Permit Number: _� �� °�~� S� Q
101
Planning and Development Services Building Permit Applicati n FEB 2 3 2021
Building and Code Regulation Division ST. Lucie Coun
tY, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION S
Address: 1�6(107 kita_fi,fJPra S
Property Tax ID t#: k3 I 1 7(A Ito 2C/ 00
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
i
Lot No. 22
Block No. _
Additional work to be performed under this permit — check all that apply:
�v Mechanical —Gas Tank • =Gas Piping _ Shutters X Windows/Doors
Electric Plumbing Sprinklers _ Generator �(_ Roof
Total Sq. Ft of Construction: 1Q Sq. Ft. of First Floor: r 7 0
Cost of Construction: $ 2.1o� ` 00 Utilities: v Sewer _ Septic Building Height:
Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE PARKWAY
City. GULF BREEZE State: _
Zip Code: 32563 Fax: 772-905-8511
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)
Pitch
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE PARKWAY
City: GULF BREEZE State: FL
Zip Code: 32563 iFax: 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 $7,500 or more, a RECORDED Notice of Commencement is required.
fit .w b� F� X$ �-s>W.Uff$ 155��.4�� M• y �`i'-�'�i.•"GAf ._itl'f2'rS �' �'$'^��' ;�: Lei . � ..fi�^(�� .b�'vIYY'J:N1��F,'ri N.ii�fli TFiF A. � �0..±''4 1.! :�?'r\ �..7eµ—'»e ., `• l � ,idl M1 r� �
,�F., k't..e .� � � r 1 y"� �i" ;�. d ) � ^5, ,,` f i -• h� t "°1 .� K �� � r�
DESIGNER/ENGLNEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name : ICeesee Aesociales Name
Address: 945 so�lr, orange 6icesortdl7aii Address:
City; Apopka State: FL City: State:
Zip:32703 P h o n e 40i-880-2333 - Zip: Phone:
`
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name;
BONDING COMPANY: _Not Applicable
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 holdentg 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 restrictiorfs -which may apply.
In consideration of the granting of this requested permit, I'do hereby agree that I will, in all respects, perform tke work
in accordarice 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." '
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature o�Cont�ractor/U=cense H�older
STATE OF FLORIDA
COUNTY OF SainlLucie
STATE OF FLORIDA
COUNTY OF Sainl Lucie
The forgoing instrqM_erjt was acknowledged before me
this � day.ofr 20�. by
The forgoing instrument was acknowledged before me
this � day of 204 by
No rYi c
ICI f
Name of p rson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced 01 DIN h
. Personally Known x OR�Produced Identification
Type of Identification
Produced K h OW IDS
at M�w
a UU1 INUO U
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Commission No. M ► 99 Notary PubhcSona
Hannah E Moore
M mmd
�m s n No. —1 I (Seal)
0
VEGETATION na Moore
REVIEW REVIEW expires 710RW}EW
REVIEWS
FRONT
COUNTER
4a w
ZO
REVIEW
Expires 07/01202
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.