HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: New Construction
Property Tax I D #: J 311 - 1,66 - (j 10,-3 — Lot No.
Site Plan Name: am,-i _�A6mes Block No. I
Project Name: P&M")V6y\eZ QE:: V�1MAr"Y\Web- V�uf,k 60..
E�TI LE®W,
Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank Gas Piping Shutters K- Windows/Doors
—
Electric Plumbing Sprinklers — Generator A Roof Pitch
Total Sq. Ft of Construction: a., b D!Sq. Ft. of First Floor:
Cost of Construction: $ [0., Utilities: Sewer —Septic Building Height:
IN -1, RD�N�VA-4'TA,
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: Address: 3000 Gulf Breeze Parkway
Zip Code: 32563 Fax: City: Gulf Breeze State: FL
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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@adarhshomes.com
from the Owner listed above) State or County License CRC1 330146
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.
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DESIGNER/ENGINEER: Applicable
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_Not MORTGAGE COMPANY: _Not Applicable
Name: ICaesee Aesoclates
Name:
Address: 945 sown ore�ge a�055om T,ai, 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."
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_Signature
of Owner/ Lessee/Contractor as Agent for OwnerSignature
tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF safntLucle
COUNTY OF BaintLude
The forgoing instrument was acknowledged before me
this day of 0 CV) 20U by
The forgoing instrument was cknowledged before me
_LL , ,
this _L�, day of _0_, 202=1 by
W ��van ►�raar�s
y� ryan ��a t�f
Name of porson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Produced _K,h Dw Y)
_
Type of Identification
Produced Y_h OW I'S
M_ak wui
a WJW ftuoAi
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. Notary Pubk
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Stelp
Hannah E Moore
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