HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Z �% 3 01 3 Z.
Building ermit Application R��FIL�D
Planning and Development Services j *4
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Building and Code Regulation Division ar?,
2300 Virginia Avenue, Fort Pierce FL 34982 St 4 ovDe
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential"Pc--°°r
y
PERMIT TYPE: New Construction
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PAR®POSED M'PROVEM�E 1 LOC4Aj O A'
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CIA r t L.> aa#M4 a, A u s 1 �.a4,13 OA, rP�;,. �r
3� ales �
Address: 4--� pey-C
Property Tax ID #: �311 " %C) bo�3 1— bbb Lot No.
Site Plan Name: ,'j I` jCLM5 rhos Block No. �
Project Name: C Qm� pM'2S �& 1 OC -W\kMe--
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Additional work to be performed under•this permit
X Mechanical —Gas Tank _ Gasp
X Electric /� Plumbing pri
Total Sq. Ft of Construction: 2-071V
Cost of Construction: $ _�� 90 b
Name Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State:
Zip Code: 32563 Fax:
Phone No.772-905-8394
E-Mail: pslpermits@adamshomes.com
— check all that apply:
Piping _ Shutters, ��// X Windows/Doors
nklers _ Generator 0l- Roof Pitch
Sq. Ft. of First Floor: 003s
Utilities: L Sewer _ Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: William Bryan Adams
Company: Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway -
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone No772-905-8394
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.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Applicable
_Not
Name: fCeeseaAssocla�es Name:
Address:945Southo�angeB�ossomTran Address:
City: Apopka State: FL City: State:
Zip: 32703 P h o n e 407-880-2333 -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, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Arpendments.
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 COMMEEMENT."
NC
Signature of Owner/ Lessee/Contractor as Agent f6r Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
The for oing instru nt was cknowledged before me
this day r
The for oing instru nt_wass af�knowled d before me
x
o 20� .by
this day o ; 20V by
Yvan Ha rof
Name of p rson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Produced_ K.n )Ny)
Type of Identification
Produced Y_In OW I\S
al wui
ftUOAJ
(J�,aKAA
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- of Florida )
Commission No. M1 N 9 No�ry Pa bhc S��
�State
oom s n No. 't I (Seal)
EIF4"�
Hannah E Moore
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