HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Planning and Develdpmen t Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: 'JAI 5— C F�-t 9
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Building Permit Application
PERMIT TYPE: New Construction
Address:
S
Commercial Residential X
Property Tax ID #: I J 11 -71CXD 'C�0`-�'I '— 000 -a-Lot No. 1
Site Plan Name:'AdoLr�ns t6 m'e's Block No. —�—
Project Name: &VAC, acme- cx�- I- 0C -�' .� Irl� Z � C.
Additional work to be performed
X_Mechanical Gas
X Electric Plu
tu
Tbing _ Sprinklers
Total Sq. Ft of Construction: "Z'B LJ-7
Cost of Construction: $ Z'75f o l5 Utilitie
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)
under this permit - check all that apply:
ank _ Gas Piping _ Shutters
X Windows/Doors
_ Generator Roof
Sq. Ft. of First Floor: ZQZ
s: XSewer _ Septic Building Height;
Name:Wllliam Bryan Adams
Pitch
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 N0772-905-8394
E-Mail pslpermits@adamshomes.com
State or County License CRC1330146
11 VGILIC u1 cunsILrUcuon is ?zouu or more, a ntLUKUtu 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 : I(eesee Associa#es Name
Address:845Southorenge6�csscmTrau 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 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-re'sidehtial 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 of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SainlLude
COUNTY OF saintLucie
The forgoing instrument was acknowledged efore me
this A� day of Marrh 20 by
The forgoing instr nt was cknowledged efore me
I
this�day of ; 201by
w � ry a n W-ra o n� s
_W . Iry a n � a �► .r
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, bW V1
Type of Identification
Produced V_hbw r�A
WOU
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. � 11 Notary Pubk Stale
Vn s n No. 1 (Seal)
Hannah E Moore
• M m
NotMIRUISMS018
Tor w
Expires 07/01/202
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REVIEW
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REVIEW REVIEW xp�res 7/0RV?,EW°�
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