HomeMy WebLinkAboutBuilding Permit Applicationr �
All APPLICABLE INFO'MUST BE COMPLETEb FOR APPLICATION TO BE ACCEPTEb
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
Permit Number: �` 01 ' Mi
C C (Q I ZLO
RECEIVED
Building Permit Application
AUG 0 3 1011
Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID N:
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Permitting Department
St. Lucie County
%tot No._Iys)
Block No:
Additional work to be performed: under this permit —check all that apply:
�v Mechanical —Gas Tank _Gas Piping Shutters
X Windows/Doors.
Electric -A Plumbing _ Sprinklers
Total Sq. Ft of Construction: I-jbej
Cost of Construction: $ 2)b(i 4pd Utilitie
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)
Generator Roof Pitch
Sq. Ft. of First Floor:
s: V Sewer _ Septic Building Height: I
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address:3000 GULF BREEZE PARKWAY
City: GULF BREEZE FL
State:
Zip Code: 32563 Fax: 772-905-8511
Phone No 772-905-8394
E-Mail PSLPERMITS@ADAMSHOMES.COM
State or County License CRC1330146
f value of construction is $2500 or more, a`RECORDED Notice of Commencement is required.
f value of HVAC is $7,500 or more, a RECCiRDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not A licable
— pp
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MORTG_ AGE COMPANY: Applicable
Name: KeeseeAssocla�es
_Not
Name:
Address:9asso��ho�a�yeeio55omrra�i
Address:
City: Apopka State: FL
City: State: -
Zip: 32703 Phone407"BB0-233]
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 obtaina permit to clothe 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, l 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 RFFnRF Drrnnnuur vnr'ro mnTl: ..� ..,....�..;.�:.�.._ „
-- - -- -�
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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 Saint Lucie
The forgoing instrument was acknowledged before me
this day of (�!:l 2021 by
The forgoing instrument was acknowledged before me
this � day of_L . , 202( by
I P�rvan ►9raarYl s
Man ftda 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_) i )N i1
Type of Identification
Produced k n uW l\S
I t_KWQk
NUOAJ
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. MIN
Notary Putnc� So®b
omm s n No. 1 (Seal)
Ipnda
Hannah E Moore
• M mmi
OF w
Expires 07/01202
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REVIEW
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REVIEW.
xpires)7/0aW
Moore
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19