HomeMy WebLinkAboutBuilding Permit Applicationr
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1S78
Permit Number: 2 l pI � ()poD
Building Permit Application
Commercial Residential X PeCstt�c ecc\)"
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID If: t 3 ! l — -7Dt A Qb y 3— n60 — oQ 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:
' Chi Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric � Plumbing _ Sprinklers
XWindows/Doors
Generator X— Roof Pitch
Total Sq. Ft of Construction: �(�(��
Sq.
Ft. of First Floor: Q
6(>q
Cost of Construction: $ -,jl, a q L
Utilities:
$ Sewer —Septic
Building Height:
5 f S
iOWNE'R%L'E$t$°E?E'rx,, ; �fTsy,{7 , s�; ,, h , >y� r
��.� �... 3 ,�.F�, - r �f, �� rONTRACTO'Rt�� �*,P "E�,'
i./�.'(.':�4v�7' _ .. .:Nwik. 3�.%� �tiFL � yvn.�-. 5�'£'n.`In.,nb t .�yvd t%�� {n i4.i.Yb-fa an. �!� ��rYY✓ b .:,k. i>/�,4it �L �iTr�k .. ..ts>4� "F .9;-�j=f
Name ADAMS HOMES OF NORTHWEST FLORIDA INC. Name: WILLIAM BRYAN ADAMS - QUALIFIER
Address: 3000 GULF BREEZE PARKWAY
City: GULF BREEZE State:
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE PARKWAY
_
Zip Code: 32563 Fax: 772-905-8511
Phone No. 772-905-8394
E-Mail: PSLPERMITS@ADAMSHOMES.COM
City: GULF BREEZE State: FL
Zip Code: 32563 Fax: 772-905-8511
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 0snn nr n,nro � ocrnonrn NL
cI1113 Fmjulreu.
f value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
F�r��;�i,�:�d���s ��a✓�'-�kr�x�%fra�>`i�.:r.�' ��"' �'�.�����,�1''``y,��. �"��
�s�?i,sf��i`�;?RF(r������'�4��-t:4��`an`����ir"�sir7�, y:�� l�'
�. MORTGAGE COMPANY: _Not Applicable
Name: {(eeseeAsaoclates
Name:
Address: 945 sou range alo55om Tra;, 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 such
prohibit
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."
C
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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 Salnti_ucfe
The for oing instrument was acknowledged before me
r�
this ��
The forgoing instrument was acknowledged before me
da of
Y �LtCI 20 by
this ( day of '�_ 20 by
� P� ry a r1 ►4ra � m s
�l. Iry a �1 ►�� � ►� f
Name of p rson making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Personally Known x OR Produced Identification _
Produced _K.n )W In
Type of Identification
Produced K Yl OW m
hnk MAW
a UW, MOAJ
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public- of Florida )
Commission No.
Notary PubkSmb
�State
n No. _` I (Seal)
AP
PATs
Hannah E Moore
Mommigam
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Expires 07r01202
REVIEWS
FRONT
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VEGETATION Rkianna Moore
COUNTER
REVIEW
REVIEW
REVIEW REVIEW expires 7r0M?fEW
DATE
RECEIVED
DATE
COMPLETED
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