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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a.,` Permit Number: aII10 ,''j - ©- s a Building Permit Applicatio ECEIVED Planning and Development Services FEB 12 2020 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting Phone: (772) 462=1553 Fax: (772) 462-1578 Commercial Residentia PERMIT TYPE: New Construction Address: -b G O Property Tax ID #: Site Plan Name: Project Name: nr l� i Gr _ "T0 —1I0- 1ZU — 06" Lot No. M.S �1 omp` Block No. Additional work to be performed under this permit— check all that apply: X Mechanical ._/ Gas Tank _Gas Piping _ Shutters� Windows/Doors y` Electric Plumbing _ Sprinklers _ Generator X Roof Pitch Total Sq. Ft of Construction: '20 6 Sq. Ft. of First Floor: 2,51-Z.3 3 Cost of Construction: $ (, Utilities: Sewer _ Septic Building Height, 'k�Yk'�,cr iRld}C�.,ii%rrairi'Z•r Ty.aN ,�.�»f�. e.G.f .. .;tru J.l. 7n .. �Y �.�?}�...li�ir.tr,.-ti)/A �r:�.;...{�:liF}ni:s' -�.�.a.M��W '-..,:. ,i �...f �Kr.1 v..�rr..e :,iYL .�I.JAY::F4iKa.��r...4iarvJ3•n_�Ad iaJ_✓d�iN��:3 Name Adams Homes of Northwest Florida, Inc.' Name: William Bryan Adams Address:3000 Gulf Breeze Parkway Company: Adams Homes of Northwest Florida, Inc. City: Gulf Breeze State: _ Zip Code: 32563 Fax Phone No.772-905-8394 Address.3000 Gulf Breeze Parkway City: Gulf Breeze State: FL Zip Code: 32563 Fax: 772-905-8511 Phone No772-905-8394 E-Mail: pslp.ermits@adamshomes.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail Pslpermits@adamshomes.com State or County License CRC1330146 it value or construction Is ,IG,UU or more, a KtCUKUtU Notice at commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. ,�.n I Yi ✓' 5 t S ;:;i � -f 4�e 'i, ' R,,, 1 ; � I -q �.P. � f, F 7 t. , i ., . `' !? f � .q i z� �, r^.`-; -.,3 �,pyx: ^.Y�.f43y��, .���f9�2'� ''�.� {�1'.4�' ry � a:i`.�'�;i tf:,�7�alx.e:ict'�=i�."�f,�.S�1�:1'.^i ..� �_:F�i'�r�;. tiJ'x.,�: t�ss.,f`;FC:� �s;��a4�R��3a�tTv....��r.5`,£itr"-•�+.;�^ t a ,irk':.:, � :+y'' r j�, 't<{� rre�f *rr� -%C JY,�f t a,g,&`'IUSk ti.;y .n.t;;+ DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: -_Not Applicable Name: KeeseeAssocfafes Name: Address: 945 So�ih Orange a�OsSom Tra,f Address: City: Apopka State: FL City: State: Zip: 32703 P h o n e 407-880-2333 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 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." �Signatureof Owner/ Lessee/Contrac �asentor Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF saint Lucie CO U NTY O F Saint Lucie The forgoing instr ment was acknowledged before me this day of 20ZI by The forgoing instrument was acknowledged before me this2Z day of ,20 Z l by y�� ry � Yl � Q YYi S 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 _011OW h Type of Identification Produced khOW 1-,S huk WW IftUo & I (Signature of Notary Public- State of Florida) (Signature of Notary Public--]Sttaate of Florida ) Commission No. V9 � ` NotaryPuftSfab • . Hannah E Moore °�� s n No. 'l ! (Seal) < < M REVIEWS FRONT O07pe ZO xpires 07/01/202 VEGETATION R o-�j�noa m Moore bS COUNTER REVIEW REVIEW REVIEW REVIEW xif09. 7/0 f(M}EW DATE RECEIVED DATE COMPLETED Rev. 2/7/19