HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR P .1 TO BE ACCEPTED
Date: Permit Number: -?InA—so,
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
Address: 0 Y\ ne-n&40, eji-o r I
..Property Tax ID #:. 1311 '701 564�q Lot No.
Site Plan Name:. Block No.
Project Name: LA�v/ ms en es e4- A/cA Ula-s:iE F or_)& Toc
Additional work to be performed under this permit- check all that apply;
Mechanical Gas Tank- —Gas Piping Shutters. Windows/Doors
Electric Plumbing Sp.rinkl-ers Generator
Y*- Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: 271) Utilities: 'XSewer — Septic Building Height
Name Adams Homes of Northwest Florida., Inc.'
Name:William Bryan.Adams
Address:3000 Gulf Breeze Parkway
Company: Adam's Homes of Northwest Florida, Inc.
City- Gulf Breeze State:
Zip Code: 32563. F . ax:
,Phone No. 772-905-8394
3000 Gulf Breeze Parkway
Address:—
City: Gulf Breeze FL
State:
Zip Code: 32563 Fax: 772-905-8511
-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)
E-Mail pslpermits@adamshomes.com
State or County License CRC1 3301.46
11 VdIUU U1 LUMEFUL110n is ?,z.-juu or more, a KtLUKUtU Notice or commencement is required.
If value of HVAC: is $7,500 or more, a RECORDED Notice of Comi-hencennent is required.
4
y�.q y �T h+� v+& '.�JvxRYgyv�ei �:'� iJ.t si�ry ,cr i'4�Y _:�.K. 7.Y+�`�h• .�3e4, �'L ;'^•: iN` �di+�y3r.!s": �Y�:y�'r -
�ySU.P,PLEMENIT�AC���
DESIGNER/ENGINEER: _Not Applicable ���LLL��� ,,��
MORTGAGE COMPANY: Not Applicable .
Name : Keesee Associates --
Name:
Ad d re5 $: 945 South Orange Blossom Trall Address:
City: Apopka State: FL City:
Zip: 32703. Phone 407-880-2333 State:
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 thew . ork and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countyy 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.IMPROY,EMENTS 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 -Olt 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
. CO U NTY O F Saint Lucie _ COLI NTY OF Saint Lucie
The forgoing instr ent was acknowledged. before me The forgoing instrument was acknowledged before me
this day of a( 20� by .-this�.` day of - �Y"(' Zpby
W �ryan aan�s rUIyl ftraWf
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced x,n m n Produced K h �W
�hh
(Signature of Notary Public -'State of Florida) (Signature of Notary Public -State of Florida )
Commission No. t/9 �p� " "Vomm*
n No.—( ! (Seal)
NotaryPuWtc Smt+a
Hannah E Moore
REVIEWS FRONT ZO VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED