HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _ • O
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Building Permit Application JUNK,
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Commercial Residential X
PERMIT TYPE: NEW. CONSTRUCTION
Address: 8
Property Tax ID #: I�� I' a ' o o a s _ o o Q - y Lot No. �I
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:
'Mechanical Gas Tank ° Gas Piping _ Shutters Windows/Doors
Electric Plumbing _ Sprinklers _ Generator �(_ Roof Pitch
Total Sq. Ft of Construction: _ I Isis Sq. Ft. of First Floor: A a1—I
Cost of Construction: $ _ 3H I 1 p Q Utilities: k Sewer _ Septic Building Height:
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Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
WILLIAM
Name: BRYAN ADAMS - QUALIFIER
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: 772-905-8511
GULF BREEZE
City: _ State: FL
Phone No. 772-905-8394
Zip Code: 32563 Fax: 772-905-8511
E Mail: PSLPERMITS@ADAMSHOMES.COM
Phone No 772-905-8394
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 S2500 or a more RECORDED Not; a ,a r .. __:
- - - - 0111—Encernent 5 requlrea.
If value 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: KeaseeAssocfates Name:
Address: 945 South orenge 6�ossom Trait 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 or and•coveriants 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 accorda'nce 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."
Ag�nature
Signature of Contractor/License Holder
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF salntLude
COUNTY OF SafntLucle
The forgoing instryjmeqt was acknowledged before me
this day of 20 by
The folgoing instrum nt was acknowledged before me
this r day of 2074by
W. �YV G. Y7 �T,I (� ►'rl 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,n DEN Y)
Type of Identification
Produced is In 0W IDS
(t� wui
(Signature of Notary Public
a WK" I ftuo U
-State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. I V9 Notary PubheStale
m s n No. —1 I (Seal)
. Hannah E Moore
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0ame Wo ad, flop,
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Expires 07/01/202
REVIEWS
FRONT
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REVIEW
REVIEW
VEGETATION{atlna Moore
REVIEW REVIEW ��xpires)7r01",EW�
DATE
RECEIVED
DATE
COMPLETED
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