HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: Permit Number:
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Building Permit Application WWI
Planning and Development Services m'rgtoq,e�ou��
Building and Code Regulation Division
Per 6t W6
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address: 6J3 5S U-,sy
Property Tax ID it: 3 71M - 01 Lot No.—/!2,9?
Site Plan Name: ADAMS HOMES
Block No. _
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Additional work to be performed under this permit - check all that apply:
'Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors
Electric Plumbing _ Sprinklers _ Generator X_ Roof Pitch
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction: Utilities: K Sewer —septic e Building Height:
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Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
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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 772-905-8511
E-Mail: PSLPERMITS@ADAMSHOMES.COM
Fax:
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 05nn nr mnro . arrnDnCn NI �7 _[ �__
. -- -- -- ..._. -0 - ..ram -i—E.- -wLICE rJ 16-omiencement =s 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 fJIORTGAGE COMPANY: Applicable
_Not
Name:I(eeseeAssocfa�es Name:
Address: s,4esou�nora�yee�o55omrra�i Address:
City: Apopka State: FL City: State:
Zip: 32703 Phone407-880-2333 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
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF SafntLucfe
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this (� day of 2021 by
this __Lb day of 20 Z( by
W. Yvan H19 wf
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
Type of Identification
Produced k now IDS
ftUOAJ
(Signature of Notary Public -State of Florida)
(Signature of Notary Public -
Public -State of Florida )
CommissionNo.
Notary pubcS
no. 'ta
(Seal)
Hannah E Moore
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Expires 07/01/202
REVIEWS
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COUNTER
REVIEW
REVIEW
REVIEW REVIEW ORr�}EW
DATE
RECEIVED
DATE
COMPLETED
Rev.