HomeMy WebLinkAboutBuilding Permit Application f
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
i Date: Permit Number _ 10-7 Q 01 Q I
L"B "E'EAM
Building Permit Application
Plonnirig and Deve�opmentSeru ces
8�rtcia� or��tdde#Z�gr�toriora�i:?���Pc��: G
230
34982
irgtrara-lc'uer+aae,•Foirerce FL
Phone:;U!2J 462-1553 Fax:(772)462-1578 commercial ,, , Residential X
[ PtRMITTYPE
W NE , CONSTRUCTION
PRO POSED;;IMPROVEMENxt3��iIQN`
A�d P Y .. .
.r
IEz55' - -
Property Tax ID# � .� .'.� /, �" r'. - LC►t N ,
Site Plan Name., A
Block Nt#
DAMS HOMES
ADAMS HQMES OF NORTHWEST,FLORIDA NC.
Profe't Name.- ._
'.:r � ' 9'at .;,}.•.. zh.._, e y�,�'-^e`..s�.xn�..'.� �,:,i , -.. �n u j �rf7r ' z .e}+ :.isn sYs�"`•,,.Y'..r..f`*���7��`-��� n;.R'i�'o-.�=lt"�'�ir>."£'.
..,..)4.wy
3 u -
.... ,. .. '. . max..
Addrtlona:work to be performed .under this permit- check all that apply.=
�Mechar cal Gii Tank Gas<Piping shutter— X Windows/Doom
E:iectri Plurnbfng ,Sprinklers Generator s_Roof Pri'eh
Totaisq,Ft of Cons tru tron '4 „� Scr Ft ;bf Fl0t Flour
d t bf Construt<t on $ .� " UWities°,. Sewer Septac Building Nesght`
i F ..:��twS w..{s:,.�., i.7 / s¢.:;• f'a k. +-jx `r . .€ » y-.,,.sn r.:4i 4 ..xya. *. 7 ,..f * e` _, ..z a.�,
z .. £3.....
+ r
k.x,...,+.s...'.'L,.� ♦K .y'..d . `
.ti
jame ADAMS HOMES OF NORTHWEST FLORIDA INC. Narne_Wl LOAM BRYAN ADAMS:-QUALIFIER„ _
„ Address:3000:GULF BREEZE PARKWAY Companya ADAMS HtN1ES OF NORTHWEST FLORIDA INC,
---
City: GULF BREEZE State: Addre 3001,GIJLFBREEZE PARKWAY.
zip Code: 32563 Fax;?72-905-85i1 Ciy GUFF BREEZE State FL f
,
Phone•No.772-905-8394 Zfp Code 32563 Fax 772 905 8511
-;F
E!Mail.:PSLPERMITS@AQAMS140MES.COM Phone No 772 9 5 8394.
S ,
Fill in feesimgle Title Holder on next page(if.different E-Mag1 PSLPER�rt1TS@RDAMSHOMES.COM
from the Owner listed'above)f State or County. + ense CRC1330146
-
If'value of constructeon'is$2500 or more;-a RECORDED Notice of Commencement is regmred.
If value of HVAC is 57,500 or more,ja RECORDED Notice of Commencement is required.
i
,
;z:,.�. -.s..k•...eye.!�,Xe.•:�a,6'n:� r5+r'cEt�r <r�.,+i 'sic .,•5>.r kw�a.•c�r:.sr y.a� �mar
S`{lpp� lV1,l3n/ ICQNSwTRU T(®N �lttA�fU ( IgOR�1'/l Y.
c2 :_,s •�7r:�z� :t ^; ' c.. r :.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:Keeseeassacates Name:
Address:945 South Orange etossam Trait Address:
City: Apopka State* Fs: City:
State:
Zip. 32703 Phone467•8e0.23W Zip: Phone:
FEE SIMPLE TITLEHOLDER: 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 Countyy.makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is it)conflict with any applicable Horne 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.
1n 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 concur^rency review:rooin additions;
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINC
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 OSTAl.k FINANCING, CONSULT .
WITH YOUR FENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT'."
Signature of Owner/tesseeJContractor as Agent for Owner Signature of Cohtractor%License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The fo�r o �Ltting instrument was acknowledged before me
this�day of ..=�t.P.YLC ,z0al by this_' l._day of l.._____^,2Q,�(by
byunnws
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 Type of Identification
Produced K.Ployh Produced Y10W hS
Uj
(Signature of Notary Public-State of Florida I (Signature of Notary Public-
�State of Florida)
Commission No. ��(,4 Koury pu„k star. s n No. 't f (Seal)
Hannah Moore
r. M
pA ERpires4NO1r20I na itApOr®
REVIEWS FRONT ZO VEGETATION Rcn, fiaQ04�
COUNTER REVIEW REVIEW REVIEW -REVIEW wspires 7j0RWf:W
DATE
RECEIVED
DATE ,
COMPLETED
7
Rev. 2/7/19