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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
,Date Permit Number: 7-� 0 (�"l�C�
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Building Permit Application
Plorining and Development Services
810ding and Code Regulation Division
2300 Virginia Avenue, fort Pierce FL 34982
Phone:-(772)4624553 Fax;(772)462-1578 Commercial Residential X
..PERMIT TYPE: N
., NEW CONSTRUCTION
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Property Tax iD 'tot No.
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Site Plan Name::ADAMS HOMES, Book I46..
Profe tNam.e�.
ADAMS.HOMES,OF NORTHWEST FLORIOA, INC.
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CNSTRUCT�ON INFO�RP�T��l�, � �.� Q ��� �
1q Y< a 5` F1..,e@ $'."_...>tT, t r. 3.=,'r^ 4 •Yk
Additional work to be performed under this permit-check all that apply,
T,1 Mechanical Gas Tank ,Gas Piping —Shutters X Windows/Doors
Electric Plumbing 1 �p Sprinklers , Generator (- {Roppof Pitch
Total SGW Ft of Constructions u fA Sq Ft.of First Floor: i d
Cost„of Construction: i Utilities: )(Sewer y Septic Building Height: 4
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Name ADAMS HOMES OF NORTHWEST FLORIDA INC. Name:WILLIAM'BRYAN ADAMS-QUALIFIER
Address;3000 GULF BREEZE PARKWAY.' Company:ADAMS]TOMES OF NORTHWEST FLORIDA INC.
city: GULF BREEZE ! # State: Address:3000 GULF BREEZE PARKWAY
Zip Code:.32563 Fax:4172-905-8511 City: GULF BREEZE State:FL
Phone No..772-905-8394 j. Zip Code: 32563 Fax 772-905-8511
E-Mail;PSLPERMITS@ADAIVISHQ(ulE S,COM. Phone No 772-905-8394
Fill in fee simple Title Holder on riext page(if different E-Mail PSLPERMiTS@ADAMSHOMES.COM
CRC1330146
from the Owner Rated above) i i State or County.License
If value of'construction is$2500 or more,a RECORDED Notice of Commencement is requrred`.
If value of HVAC is$7,500 or more,a-RECORDED Notice of Commencement is required.
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DESIGNER/ENGINETR: Not Applicable MORTGAGE COMPANY: `Not Applicable
Name±KeeseeAssociates Name:
Ad dress:,34s south Orange Blossom Trail Address':-
Clty: Apopka_ State: Ft, City::,. Stater
Zip- 32703 Phone447.886:2333 'Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: YNot'Appticable
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 iindicated,
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representationthat is granting a permit will authorize the permit holder to build the subject'structure
which is in conflict with any applicable Nome 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 con currericy review:-room additions,-
accessory structures,swimming pools,fences,walls,,signs,.screen roams 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'MIDST 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 Harder
STATE OF-FLORIDA STATE OF FLORIDA
COUNTY OF Sa.n+1.uoie COUNTY OF s-R
The f r ping instrument was acknowledged before me The fopRrP�oing instru ent was acknowledged before me
this ;day of 20a by this t4 day ofJMV 20 al by
Abu ayi stj a ro ,
Name of p rsonmaking statement. Name of person making statement
Personally Known X 08 Produced Identification Personally Known x OR Produced Identification _
Type of Identification Type of Identification
Produced DIM yl Produced K Kl OW (�
ftuoU
(Signature of Notary Public-State of Florida} (Signature of.Notary Public-State of Florida
Commission No. 40 NvL+Y Public S4r♦ mm
s n No. (Seat}
Hannah E Moore
M
�4 s Eirpaes 071011102 o
REVIEWS FRONT ZO VEGETATION _ R =la®
COUNTER REVIEW REVIEW' REVIEW REVIEW WWI"1`710KNIIIEW'.
DATE „
RECEIVED
DATE
COMPLETED. - . "
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