HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Z 3 " S�
p 4 a
CIO,
0 0 u
Building Permit Application b j
Planning and DeveloprrnentServices
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:
�-CO 9 Lot No.21-1
Site Plan Name: OLM M' Block No.
IS I nn��
Project Name: N&VArj i�or"
'r*xa,.mrrauamcrxna�ta,xrrraarx�xa'�e'a�k+��r��
.Y.rt'k,`�'
3642ri `i/ , cd �l,eah o� A
4 CONSTRUC�TION�INFOR;MATION �.�`� �`�� ��. ��,,�,, &����-L�:;- •.� -���� 7 ''�i' , .:; f� 7'�
Additional work to be performed under this permit - check all.that apply:
X Mechanical Gas Tank ' ' ' _ Gas Pipp]i _ Shutters 1 Windows/Doors
X
Electric n Plumbing 5 klers _ Generator A Roof Pitch
It 74y
Total Sq. Ft of Construction: 2-� Sq. Ft. of First Floor:
Cost of Construction: $ _2pq I q (�O Utilities: [ Sewer _ Septic Building Height:
Name Adams Homes of Northwest Florida, Inca Name: William Bryan Adams
Address:3000 Gulf Breeze Parkway Company: Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze State: _ Address:3000 Gulf Breeze Parkway
Zip Code: 32563 Fax: City: Gulf Breeze State: FL
Phone No. 772-905-8394 Zip Code: 32563 Fax: 772-905-8511
E-Mail: pslpermits@adamshomes.com Phone No772-905-8394
Fill in fee simple Title Holder on next page ( if different E-Mail Pslpermits@adamshomes.com
from the Owner listed above) State or County License CRC1330146
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. 6Q�
ER/ENGINEER: _ Not Applicable
Name: Keesee Associates
Address: 945 South Orange Blossom Trail
City: Apopka State: FL
Zip- 32703 Phone 407-880-2333
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
UVVIvtK/ LUIV I KALI UK AII-IUVI I : 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 5t. 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."
c � 212
Signature of Owner/ Lessee/Contractor as Agent for 0 ner
STATE OF FLORIDA
CO U NTY O F Saint Lucie
The forgoing instLment was acknowledged before me
this day of F rLL0d 20-V by
y��rya n 14raa rYl S
Name of p rson making statement.,
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. 1-465941sto
f!75_%Notary Public Soda
Hannah E Moore
REVIEWS COUON ER I ROEVIEW REVIEW
RECEIVED
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged efore me
this day of l (Dt uAr 20 0 by
Name of person making statement.
Personally Known x OR Produced .1dentification
Type of Identification
Produced 14 h t)W I`S
l a UUL Y' W vU
(Signature of Notary Public- State of Florida )
n No. Oil l (Seal)
VEGETATION
REVIEW REVIEW