HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:C1
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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
PERMITTYPE: New Construction
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Address: C)
Property Tax ID #
Lot Nn_
Additional work to be performed under this permit — check all that apply:
K Mechanical —Gas Tank ' _ Gas Piping _ Shutters Windo'ws/Doors
y` Electric n Plumbing _ Sp.rinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: (� b 3 Sq. Ft. of First Floor: Zb C�
Cost of Construction: $ _ Z9 3 , c 0C Utilities: Sewer _ Septic Building Height_
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
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 No 772-905-8394
E-Mail Pslpermits@adamshomes.com
State or County License CRC1330146
—, u 1MUL16c Ui wniinencemen[ is requlreo.
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:
.�>�"
Not Applicable
Name: Keesee Associates
_
N a m.e:
Address: 945 3euth orange Biesscm rraii
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, 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Saint Lucie
The fork ing instrum t was a knowledged before me
this �5 day of o'/cr 20� by
Name of P rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced K h W
(Signature of Notary Public- State of Florida )
Commission No. VIM
i� Notary Public So®t®
�; Hannah E Moore
REVIEWS FRONT ZO
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrum nt was acknowledged before me
this �ay of Rr , 20-q by
w. an
n
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced YlDW P11
t a UUk AUOAJ
(Signature of Notary Public- State of Florida )
No. 'l 1 (Seal)
096� VEGETATION
REVIEW REVIEW