HomeMy WebLinkAboutBuilding Permit Application1, ---e
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and 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
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Address: _S 3 673 W6
Property Tax ID #: 1311-70 1-0C) ZA 0 00- -2- Lot No.
'Site Plan Name:.,�JeLm,5 �6m�es
- Block No.
Project Name:
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3 1-3 67Z 7- !PiA
Additional work to be performed under this permit— check all that apply:
Mechanical Gas'Ploing
—GatTbnw Shutters 'W'indow's/D,00rs
Electric kPlumbing Sp.rinklers Generator A Roof Pitch
Total Sq. Ft of Construction: -7 Sq. Ft. of First Floor:
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Cost of Construction: $ 2-5- 7 C', --- Utilities: X—Sewer _ Septic Building Height:
�58,6 N .1; 57�TW M1 511. URN
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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: 325.63 Fax: 772-905-8511
E-Mail: pslpermits@adamshomes.com Phone No 772-905-8394
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 CRC1 330146
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.
DESIGNER/ENGINEER: ' _ Not Applicable
Nam e : Keesee Associates
Add ress: 945 South Orange Blossom Trail
City: Apopka State: FL
Zip: 32703 P h o n e 407-880-2333
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip: _
Phone:
Not Applicable
State:
_Not Applicable
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 coveriants.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 here* b 'gree that'( 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."
nature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF Saint Lucie COUNTY OF Saint Lucie
The forgoing instru nt was acknowledged before me
this a day of nAC.r�j 202J by
Name of person making statement.
.i
Personally Known x OR Produced Identification
Type of Identification
Produced 0) (MY)
(Signature of Notary Public- State of Florida )
Commission No. a,� o�
f?Lar%
Notary Pubhc S=*
Hannah E Moore
REVIEWS FRONT
I COUNTER I REVIEW REVIEW
RECEIVED
DATE
COMPLETED
ev. T17TTT_
The forgoing instru ent was acknowledged me
this L. day of Ir%-X 20 Z by
W . Iry a �1 Ytrl � . f
Name of person making.statement.
Personally Known x. OR Produced Identification _
Type of Identification
Produced Y_n bW I`S
: la UWOO
(Signature of Notary Public- State of Florida )
n No. t 1 (Seal)
nQ6&4W VEGETATION
REVIEW REVIEW