HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIVIPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PermitNumber:A 1•LJ-Z
Building Permit Application
Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID #: / 3 // 9,6d — ,0d L/6 — UUU _S
Lot No.
Site Plan Name: ADAMS HOMES
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
— Electric Plumbing _Sprinklers —Generator � Windows/Doors
�(_ Roof
Pitch
Total Sq. Ft of Construction: blt 54) Sq.�F1t. of First Floor:
Cost of Construction: $ �b�E �pC� 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.
i - el —A"
L^ :�5 `s .i sEry i�. "(�:ta:7�trr�"r "FL'r-...CX?.� -. .A�Z�xgY�� :rti�X£ r r rfy ry ,r_�Ai're('k�fq':,%f+�F" :�:'�w 7.. r.+���&'�4•`'.;� .xyi r xT rn •y:,o•-•:,�
��S,;U�PPLCIx.M:E�N�T�AL�Cu®.�NS�TR�UTI;ON LIE�N�L�A�W�IN�FORF.ATIO�N�: k , `�?�1„ �;ir � fl: ��r :iY�•1�' '�'�`�"
h �S.
.Si .F: :-C� �'Y3i�� YY..��� �•�.yk �/ MyF �v 2 r, "y{ i � y,�@J- .y � n31 �lN�l�:.r4
mil'', t �-•
'
-N1
.�r,i".F W.��j- •- 7�.�{l;
+�-��-. ..�s G 7� s. t.H �.
J.Yt�-��'�''f. �• s�r..if ., 4 �G"�f�`':ir:�t�i�:� i'�,�..c'4rr°s�F.', �.,�.�'�'�,
DESIGNER/ENGINEER: , _Not Applicable MORTGAGE COMPANY: Applicable
_Not
Name: KeeseeAsso�fa�ea Name:
Address: 94s soum orange a�o55am T,a„ 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 thaE.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 013TAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
�
�of
t
Stignature Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SainlLucie
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20d-( by
this �L day of zp 24 by
uan NorY1 S
byVayi ff)a 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 K.Y1 D W h
Type of Identification
Produced k h O W PIS
WOU
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. �/� Notary PubkSte�
C
om�am s n No. —( 1 (Seal)
Hannah E Moore
• M mi
0
OF w
Expires 07/01/202
REVIEWS
FRONT
ZO
VEGETATION na Moore
R om 160VO
z
COUNTER
REVIEW
REVIEW
REVIEW REVIEW expires P1004fEW
DATE
RECEIVED
gr'"
DATE
COMPLETEDi
rr,
ev.27 7 7 19