HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f
Date: 6. Q[ I rC Permit Number: _z:,?! V r '% .y1�
3-7t
RIECEIVED
Build ng Permit Ap licatiaWL 15 �021
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St■ Lucie C I
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Unty� FL
PERMIT TYPE: NEW CONSTRUCTION
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Address:-6 3 /
PropertyTaxlD#:
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Lot No.__
Block No.
Additional work to be performed under this permit - check all that apply:
W_Mechanical _ Gas Tank _ Gas Piping _ Shutters is. Windows/Doors
Electric Plumbing _ Sprinklers _ Generator X- Roof Pitch
Total Sq. Ft of Construction: 3t)c).�3 Sq. Ft. of First Floor: no
Cost of Construction: $ 3a!q tow Utilities: Sewer _ Septic 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.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Applicable
_Not
Name: Keesee Aeaociates Name:
Address: 948 South orange 6iaseomhait Address:
City: Apopka �. State: FL City: State:
Zip: 32703 Ph one407.880-2333 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFI'DVIT: 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 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."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
The for oing instrunt was acknowledged before me
this day ofml.L(U 20__,A by
The forgoing instrument was acknowledged before me
this
—Rday of _ dE 20,;L by
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JAI . �YV � rI � a �► 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.i1 Ow n
_
Type of Identification
Produced Yl OW IDS
WUJ
wu�_ NU 0AJ
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public Sta�te of Florida )
Commission No. �/�
s n No. q pI
Notary PubheSmtas
Vn (Seal)
.Hannah E Moore
M mmi
7orR
EKpires07/01202
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REVIEWS
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Moore
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
VjEzpires
ORMEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19