HomeMy WebLinkAboutBuilding Permit Applicationd
All APPLICABLE INFO. MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: b ��' ��oLD"/
-- - - 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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PftOPOS�EDIMJ"PQROUEMEN�LO'COITION
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Address:
Property Tax ID #: )) 1 co d i— v�C>— ® Lot No. 13
Site Plan Name: O`er& Block No: _Z.
Project Name: _
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Additional wo.rk to be performed under this permit- check all that apply;: ,
Mechanical Gas Tank _''Gas Piping —Shutters Windows/Doors
X Electric n Plumbing _ Sprinklers Generator X Roof Pitch
Total Sq. Ft of Construction: �2-0 Sq. Ft. of First Floor:
Cost of Construction: $ �� � ®O Utilities: 'Xsewer _ Septic Building Height:
�O,WN ER/:LES^S'JCsE'"+��� � n t�` � : �� �, ..�E�
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Name Adams Homes of Northwest Florida, Inc.'
_
Name: William Bryan Adams
Address:3000 Gulf Breeze Parkway
Company: Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze State: _
Zip Code: 32563. Fax:
Phone No, 772-905-8394
Address:3000 Gulf Breeze Parkway
City. Gulf Breeze State:' FL
Zip Code: 32563 Fax: 772-905=8511
Phone No772-905-8394
E-Mail:Psipermits@adam'shomes.com
Fill in fee simple Titie Holder on next page ( if different
from the.Owner listed above)
E-Mail pslpermits@adamshomes.com
State or County License CRC1330146
vauc uLuJuu uLLwn 1b .?cauu or more, a ►cMunutu Notice of commencement is required.
If value of HVAC is $7,500 or morel a RECORDED Notice of Commencement is required,
E rv- .. _.r:.� 4,v'��:�.ur
DESIGNER/ENGINEER. — Not Applicable MORTGAGE COMPANY: Not Applicable
Name : Keesee Associates - Not
Address: 945 South o�a�9e Blossom Trail Address:
City: Apopka State; FL City: State:
Zip: 32703. _ Phone 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) ristallation as indicated.
I certifythat no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that his granting a permit will authorize the permit -hold or 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 reviewyour deed fo"r 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 fullconcurrency review: room additions,
accessory.structures, swimming pools, fences, wall, signs, screen rooms and accessory uses to another non residential pse
"WARNING_TO_.OWNER::-YOUR FAILURE; TO RECORD 'A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE.-OR,IMOONEMENTS.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 4
STATE OF FI IDA STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF saint Lucie
The for oing iiistr ent was acknowledged before me The forgoing instrum nt was acknowledged before me
this H day of Y (� 202i by: this I day of 20 b
�rvan �aam�t � rya�l �aa �►f
Name of pbrs.on making statement. Name of pe.rso:n. making statement. '
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification T Type of Identification
Produced K ii W Y1 Produced K. h OW 1�S
(Signature of Notary Public- State of Florida )
Commission No.
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
REVIEW
MOB
(Signature of Notary Public --State of Florida )
Notary PubhoSgate prlmdam s n No. 9 (Seal)
Hannah E Moore
M rnmi
E>rPires 07/o12o2 0So
VEGETATION Rom r, A9$IV
REVIEW REVIEW REVIEW �zpires 7�Ojq�