HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO, MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7�
Date: �t 1 a -24 Permit Number:
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) 462-1518 Commercial Residential X .
PERMIT TYPE: New. Construction
Address:
Property Tax I D #: 1 -3 - 7D% Lot No. / 0
Site Plan Name: Ge,VVt� yrtQ-S / Block No.
t
Project Name: �d r.('�j�p� � toy a�fC�T�A p
Additional work to be performed under this permit — check all that apply:
X Mechanical Gas Tank _ Gas Piping _ Shutters Windows/Doors
Y` Electric Plumbing _ Sprinklers _ Generator A Roof Pitch
Total Sq. Ft of Construction: _aQQC yz Sq. Ft. of First Floor: � C)
Cost of Construction: $� l d Utilities: '/Sewer _ Septic Buildi g Height:
Name Adams Homes of Northwest Florida, Inca
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 N0772-905-8394
E-Mail pslpermits@adamshomes.com
State or County License CRC13301.46
f value of construction is $2500 or more. a RECORDED Notice of Commencement is rpniiirprl
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
-
Name:
Address: s4ssoutnorange6iossomrrait
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 bylaws
rules, 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."
�Cont�ratorlU=censeHolder
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY O F saint Lucie
COUNTY O F saint Lucie
The for going instr ent was 1acknowledged -before me
this day � V_
The forgoing instrument was acknowledged before me
of 20IJ by =
this I I day of (M W_ _ Zprl_ by
� � ry � n i4ra a n� ,s
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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
Type of Identification
Yi OW 1�S
ProducedWWJ
NUCAJ
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(Signature of Notary Public -State of Florida)
(Signature of Notary Public- State of Florida )
Commission No.. 1D9 .r� NoiaryPuphcSta1B
o s n No. q I (Seal)
:9 , Hannah E Moore
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