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Home My WebLink AboutBuilding Permit Applicationr- 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: lD' / '') ) Permit Number: — V Y%` -" om Building Permit Application RL'nre® Planning and Development Services Building and Code Regulation Division JUN ® 4 -20?1 2300 Virginia Avenue, Fort Pierce FL 34982 IAermitting Department Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential At.LucleCounty PERMIT TYPE: NEW CONSTRUCTION Address: Property Tax ID it: 1 :) I 1 - , 0 1 ^ D 0 - 00 _ S7 Lot No. Site Plan Name: ADAMS HOMES Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC. Block No. _ �• Additional work to be performed under this permit - check all that apply �v Mechanical — Gas Tank, _ Gas Piping — Shutters is Windows/Doors Electric Plumbing —Sprinklers Total Sq. Ft of Construction //: M -1 Sq. Cost of Construction: $ p( g?j. L-10O Utilities: — Generator Ft. of First Floor: Y_ Sewer — Septic , K_ Roof Pitch I u a 0 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 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. f �; ra+E r� �tir f d ;t(ksR��' x �,��. �fSt�it '- rr+*4%Xr` +.��v{v's - ��s�',Y-1£ �n�, {�h"tyr✓r.! p4b4:%'t'{.,{�Ya'�3"' r f� �3. i' °'' �.la�i" a �+M".�tA�.ri_'=''��.Y,+,S f �r'� 6.��i s.C��hf'T'!iY�' �.-iNp+�}fi3Y✓ly�r`X:�'.:ad ih'+3i;�,��i�"x`x'".'+��S` ^CT�-1!C',Y+` �t4 �j' �''��'�+'�u'�,�`�'w �.yt`(�5��3��Y-"?��x ,,. �r �8.� x._k. � ?��k$.G�•t'n�. `.. �tY � ��t.?L�F�z��-. �s .,:Yt�'Nez. ,:t�F��Zt us: � �.''Ga: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable j Name ; Keesee Associates Name: Addre$$: g45SoulhOrangeBlossomTrail Address: City: Apopka State: FL City: State: Zip: 32703 Phone407.880-2333 Zip; -Phone: FEE SIMPLE'TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not 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 subjectstructure 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." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF sain(Lucie COUNTY OF SainlLucie The for oing instrument was acknowledged before me this day of j \ 209 by The fo cling instrument was acknowledged before me _a 11XL— l/��YL.Q , this day of. �_ `,Q 20011 by N buan Nom S _w. Irvin Ho mf 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 I) w _ Type of Identification Produced K h OW IDS . __H at wyj al, N WWAJ (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. �/� NotaryPub cSdb p m s n No. q I (Seal) .Hannah E Moore M mmi 0 toic Swig of FP Oa w Expires 07701202 REVIEWS FRONT COUNTER ZO REVIEW REVIEW na Moore VEGETATION R1W REVIEW REVIEW �><pi es 7�0Rr WEW� DATE RECEIVED DATE COMPLETED ev.