HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
22
Date: Permit Number: a J" 00/3%
RECEIVED
Building Permit Application
Planning and Development Services MAR 0 5 mi
Building and Code Regulation Division Permitting Departrnar`
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Coun`'
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: New Construction
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Property Tax ID #:
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Site Plan Name: 'AJOi.M i 6M-eS Block 2..
IS No.
Project Name: r mAc" aames
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Additional work to be performed under this permit — check all that apply:
LMechanical _ Gas Tank _ Gas Piping —Shutters Windows/Doors
X Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction. 3'33y' Sq. Ft. of First Floor:' 21S_1y
Cost of Construction: $ �� co Utilities: Sewer _ Septic Building Height,
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01N�NERLES^SEA ' `'s;t hr,•
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: psipermits@adamshomes.com Phone N0772-905-8394
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. 6v 7
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DESIG,JVER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Applicable
_Not
Name : i<eesee Associates Name
Address: 945 Soutl, orange eio55om Traii 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 rules, bylaws &'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 thaVI will, in all respects, perfbi•m the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Arpendments.
The following building permit applications are exempt from undergoing a full con currency review: room additions;
accessory structures, swimming poolsjences, walls, signs,screen rooms and accessory uses to another non-re'sidential 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 COMMENCCMENT2'
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Signature of Owner/ Lessee/Contractor as Agefit for Owner
S`ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
The for oing instru nt was cknowledged before me
this day of r' 20 by
The forgoing instrum t was a knowledged before me
this day of f _ 20� by
w P�rv�n ►4raom s
W. �rya� Haws
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.n � W ►'1
Type of Identification
Produced IC Il'1 OW Is
ULU wou
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- of Florida )
Commission No. M-1 �/� Notary Pa SIAID
�State
om s n No.)—( I (Seal)
1prida
Hannah E Moore
• M m i
No
of
Expires 07/01/2
REVIEWS
FRONT
ZO
VEGETATION na Moore
_\A�xplres
COUNTER
REVIEW
REVIEW
REVIEW REVIEW OKMEW
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19