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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: jj Permit Number: _ lo- ©s� - - C OF (i Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1SS3 Fax: (772) 462-1578 Building Permit Application Commercial Residential X PERMIT TYPE: NEW CONSTRUCTION Address: Property Tax ID N: 13 11 - 7 Da 66 a I, D60 .a Site Plan Name: ADAMS HOMES Lot No. Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC. Block No. _ Additional work to be performed under this permit - check all that apply: �v Mechanical —Gas Tank _ Gas Piping Shutters Windows/Doors Electric -A Plumbing _ Sprinklers _ Generator K- Roof 2 Pitch Total Sq. Ft of Construction: 34a� Sq.. Ft. of First Floor: �p� Cost of Construction: $ �jg5-� ey 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: AUAMS 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. ti�'is� - .,^t.'�X.-': t-..T.:,:ill'�3.LSFa'�se:or:�'i�yn.�,i� SIGNER/ENGIN.EER: _Not Applicable Name: MORTGAGE COMPANY: Not Applicable Keesee Associates Address: 945 South Orange Blossom Trail Name: city; Apopka Addre.S State. FI. City: Zip; 32703 Phone407-880.2333 Y State: Zip Phone: FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Name: City: Address: Zip: Phone: City: 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 y work or installation has commenced prior to the issuance of a permit. makes on which is noconfli t with anyapplicableapplicablelHomeaOlwners Associationnting 2 lru rull les, or andhe pcovenantit holder that mayrestrict the ojrproh bit 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 `assAgent for Owner STATE OF FLORIDA CO U NTY OF saint Lucie The forgoing oing instru . ent was acknowledged before me � this LL day of 20ZI by Name of person making statement. Personally Known x OR Produced Identification Type of Identification Produced _Kn Ow n (Signature of Notary �briuState of Florida Commission No. _ I 9 q Q., ,�,. ���i� Notary PuDhc S�1a _ Hannah E Moore REVIEWS I FRONT I ZOI� COUNTER REVIEW DATE RECEIVED DATE COMPLETED I ttpires 07/01202J Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Saint Lucie The forgoing instru ent was acknowledged before me 6-- this — day of , 2021 by A bua� ftuam-f Name of person making statement. Personally Known x OR Produced Identification Type of Identification Produced Y-n o W IDS (Signature of Notary Public- State of Florida ) No. -1 1 (Seal) REVIEW REVIEW I VEGETATION W