HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 8-3-21N
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:���
Building Permit Application RFCFI�,Fo
Planning and Development Services qU
Building and Code Regulation Division G®
2300 Virginia Avenue, Fort Pierce FL 34982 i[�i� pS�9 � �Q1�
Phone: (772) 462 1553 Fax: (772) 462-1578 Commercial ResidentiE' fiCI �.Pparr_
PERMIT TYPE: NEW CONSTRUCTION
Address: 11) VC5%Je_n::__
Property Tax ID #: 11 //-'7l�J- p 1 y5 Dip 3 Lot No. _
Site Plan Name: ADAMS HOMES us bkeXskt1,3 re.
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Block No. _
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA. INC.
Additional work to be performed under this permit — check all that apply:
C� Mechanical _ Gas Tank _ Gas Piping _ Shutters iX Windows/Doors
Electric Plumbing _ Sprinklers _ Generator X— Roof Pitch
Total Sq. Ft of Construction:Sq. Ft. of First Floor: / �Q
a
Cost of Construction: $ 3D7, Libb Utilities: )(Sewer —Septic Building Height: /
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Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Address: 3000 GULF BREEZE PARKWAY
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
City: GULF BREEZE State:
Address: 3000 GULF BREEZE PARKWAY
_
Zip Code: 32563 Fax: 772-905-8511
City: GULF BREEZE FL
State:
Phone No. 772-905-8394
Zip Code: 32563 Fax: 772-905-8511
E-Mail: PSLPERMITS@ADAMSHOMES.COM
Phone No 772-905-8394
Fill in fee simple Title Holder on next page ( if different
E-Mail PSLPERMITS@ADAMSHOMES.COM
from the Owner listed above)
State or County License CRC1330146
If value of construction is 00n nr mnrn ocrrmncn
- - .. .".1%cci13nnt 1b requireo.
f value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGIN,EER: Applicable
_Not MORTGAGE COMPANY: _Not Applicable
Name: fCeeseeAssoclates
Name:
Address: saesoumoan9esios5omra�i - 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sig -nature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SaintLucie
COUNTY OF.SaintLucie
The forgoing instrument was acknowledged before me
this day of 'I
" Jif 20_.A by
The forgoing instrument was acknowledged before me
this J1 day
-4
of 20by
U
Haws
Name of p6rson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Produced K_tlbNV1
Type of Identification
Produced Y_nT3WIDS
WOU
(Sig nature Notary Public-
. of State of Florida(Signature
of Notary Public- State of Florida
Commission No.
Notary Pubft State
PM . s nNo. )�1Dq9 (Seal)
49
Hannah E Moore
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Expires 07/01/202
REVIEW
DATE
RECEIVED
DATE
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COMPLETED