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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/16/2021 Permit Number: & o •��OL�
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Single Family Residence Remodel
PROPOSED] MPROVEMENT, LOCATION
Address: 700 NW Winters Creek Road
Property Tax I D #: 4422-815-005-000-5
Site Plan Name: Harbour Ridge -Plat 21-Lot H (OR 857-1512: 3385-760)
Project Name: Horrocks Remodel/Rennovation
9
Lot No. H
Block No.
DETAILED'DESCRIPTION OF WORK::
Single Family Residence Remodel/Rennovation - New Rennovation Interior Floor Plan, Revised New Plumbing Layout,
New Electrical Layout, Typical Window Flashing Details
New Electrical Meter N/A
Second Electrical Meter N/A
CONSTRUCTION. I.NFORMAT, ION:
Additional work to be performed under this permit —check all that apply-
-Mechanical _ Gas Tank _ Gas Piping _ Shutters ►' Windows/Doors _ Pond
Electric ✓Plumbing _Sprinklers
Total Sq. Ft of Construction: 4795UA/7143UR
Cost of Construction: $ 650,000
Generator _ Roof 8/12 Pitch
Sq. Ft. of First Floor: Same
Utilities: _Sewer _Septic Building Height: 22Ft 10 In
OWNER/LESSEE: ,, . ''
CONTRACTOR:
Name Catherine Horrocks JR)
Name: Richard A. Adams III
Address:700 NW Winters Creek Road
Company: RA Construction Corp of the Treasure Coast
City: Palm City, FL State: _
Address: 850 N. Federal Hwy., Ste. 226
Zip Code: 34990 Fax:
City: Stuart State: FL
Phone No. 772-579-2599
Zip Code: 34994 Fax: 772-446-4514
E-Mail:
Phone No 772-446-4576
Fill in fee simple Title Holder on next page ( if different
E-Mail AdminAssist@HomesByAburton.com
State�or County License CGC1520713
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required:
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN .LAIN dNFORIVIATION
DESIGNER/ENGINEER: _ Not Applicable
Name : STANLEY FORREST
Address: 2567 RIDGEWAY DRIVE
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: KISSIMMEE State: FL
Zip: 34746 Phone407-997-8000 ExT 5153
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspect,' n. If you intend to obtain financing, consult
or recor in witMen,der or an attornevbefore commencing work pAur Notice of Co nencement.
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Signature of Owner essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
Swor o (or affirmed) and subscribed before me of
Swor to (or affirmed) and
subscribed before me of
Physical Presen or Online N tarization
Physical Presen a or
Online Notarization
this gpday of 202� by
this jlday of
2020 by
RICHARD A. ADAMS III
RICHARD A ADAMS III
Name of person making/statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known
OR Produced Identification
Type of Identification'
Type of Identification
Produced
Produc
4
(Signatu fe of
(Signature of lwruu-
YPu''•.. CHERYLA. FINK
`_°:` `: Notary Pub11C Sta aL� orlda
Commission N 51
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Commission No <
CHERYLA. FINK
No Public -State da
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• ommisslon N G�ZT6
5 My Comm. Expires May 13, 2022
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My Comm. Expires May 13, 2022
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