HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �(a d (04�1
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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
Address:
Property Tax ID #: Lot No. (�
Site Plan Name: Qm.�11 tAw)es Block No.
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Project Name:�a11
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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 Roof Pitch
Total Sq. Ft of Construction: lsl� Sq. Ft. of First Floor: ZZ 1 7
Cost of Construction: $ 3`I �a 1 0 0 Utilities: � Sewer _ Septic Building Height:
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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: _ 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.
DESIGNER/ENGINEER: _Not Applicable
N a m e: Keesee Associates
Address: 945 South orange Blossom Tram
City: Apopka
Zip: 32703
Phone 407-880-2333
FEE SIMPLE TITLE HOLDER
Name:_
Address:
City:
Zip: —_
Phone:
'1\A/AICo / -ter m w
State: FL
Not Applicable
MORTGAGE. COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip: Phone:
Not Applicable
- -- -�••i —m rovvilI : Application is nereby 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 subjeci.structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covena'nts'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 respecis,' 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 FINA111 ING,:,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.",
ature of Owner/ Lessee/Contractor as Agent
STATE OF FLORIDA
COUNTY OF Saint Lucie
er I Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
R
The forgoing instrument was acknowledged before me The forgoing instrument was cknowledged before me
this --a-day of �(Ylr m—y-) , 2021 by this � day of rl a , 20!LA by
h bau i► do m e N. hyuyi Hams
Name of p rson making statement. Name of person making statement.
Personally Known x Oa Produced Identification Personally Known x OR'Prgduced Identification
Type of Identification Type of.ldentification'
Produced_ Kn DW Y1 Produced K h ow f"IS
(Signature of Notary Public- State of Florida )
Commission No. D1`10q?,�4� NoaryPu��°^
Hannah E Moore
REVIEWS FRONT ZO
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
._l_Va L"' MOU
(Signature of Notary Public- State of Florida )
n No. -( I (Seal)
VEGETATION
REVIEW REVIEW