HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO
y,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "7` `4 u' �� Permit Number:
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Building Permit ApplFAPR'2
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Planningand Development Services 2021
Building and Code Regulation Division Permitting D
2300 Virginia Avenue, Fort Pierce FL 34982 9 Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial RESWdMialeMQLl ty-� FL
PERMIT TYPE: New Construction
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Address: -�T-7 I- 'LL4, q oSa'
Property Tax ID #: 1511 r% (� oc) 0 Lot No. � 3
Site Plan Name: .,"CLfy),5 bew es Block No.
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Project Name: U p !y J�kJ
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Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank ' _ Gas Piping _ Shutters� Windows/Doors
y` Electric Plumbing _Sprinklers _ Generator A Roof Pitch
Total Sq. Ft of Construction: 2 Lf d� Sq. Ft. of First Floor: js�,z'c>
Cost of Construction: $ Utilities: _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:psiperrriits@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.
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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 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 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."
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��S:x P�PL ,MFE�NT�A°L� � r= • :������,.,�F,,� -��.t, , �-��,.�
DESIGNER/ENGINEER: y _Not Applicable .
Name: Keesee Ass°��a�es
,� �; �> .7� ,�.�� �� , .,��.fi�, - ,�,'.. ry;�.,
MORTGAG.E COMPANY: Not Applicable
Name
Address: sass°�mo�a�9eei°ss°mrreu
Address:
City: Apopka 1,, State: F�
Zip! 32703 PhOne407-880-2333
City: State:
Zip: � Phone:
FEE SIMPLE TITLE"HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City: - -
City..:
Zip: Phone:
Zip: Phone:
3�10. U
�31
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sain«uae
COUNTY OF Sa��«ucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of _ IMA.rCh , 20 Z� by
r��1 , zo� by '
this � day of �Y1Ci.C'Non
Num�
N. ry �. n Hams
.
Name of p r'son making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification -
Type of Identification
Produced
Produced � Yl OW I�
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