HomeMy WebLinkAboutBuilding Permit Applicationr-
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
RECIrM
Building Permit Application JUN 041021
perMitting Depertmeft
5t. Lucie County
Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID tt: 3I ", 1 00l4 1 . OOO — —1 ,
Lot No._] �
Site Plan- Name: ADAMS HOMES
Block No. _
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Additional work to be performed under this permit — check all that apply:
Mechanical .—Gas Tank ' . _ Gas Piping Shutters
— � Windows/Doors
Electric N Plumbing _Sprinklers _Generator �(_ Roof
nn Pitch
Total Sq. Ft of Construction: a �I I Sq. Ft. of First Floor: I I P3S
Cost of Construction: $ , , —1 D Utilities: Y Sewer _ Septic Building Height:
Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE PARKWAY
City: GULF BREEZE
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)
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE'PARKWAY
City: GULF BREEZE State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone No 772-905-8394
E-Mail PSLPERMITS@ADAMSHOMES.COM
State or County License CRC1330146
I value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Fvalue of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:
� Applicable
_Not
Name : 4Ceesee Assocla�es
Name:
Address: 945 3oulh orange 6�oesomTraf� 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.: 2.
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 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 heFeby'agree tha0 will; in all respects,•perfolirm 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' FINANCING G,':' 0' LT
WITH YOUR LENDER OR AN ATTORNEY BEFORE IRECORDING YOUR NOTICESOF'COMMENCEMENT"
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY O F Saint Lucie
COUNTY O F Saint Lucie
The f going instrument was acknowledged before me
this day of jML—A-Q 20Q I by
The for ping instrument was acknowledged before me
this day of �j� _ 2007I by
�� ry � n 19->^a (� rYl S
1� . �Y� a �l �,I � �Y►" f
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.nDWV)
Type of Identification
Produced khOWIDS
f% Uj
WOU
(Signature Notary Public- State
of of Florida)
(Signature of Notary Public- State of Florida )
Commission No. �� NotaryPubbcStoop
mm s n No. 1 I (Seal)
Hannah E Moore
• M mmt
7 of
Expires 07/01/202
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