HomeMy WebLinkAboutBuilding Permit ApplicationV,
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED S90
Date: Permit Number: 4 1'^ oo •�
L
Plonning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
Building Permit Application RECEIgED
2021
Permitting Departm
Commercial Residential X st.Lucie County
PERMIT TYPE: NEW CONSTRUCTION
Address: Kid y 'I"MAdT-1 e
Property Tax ID a: 3�(- '�Qa - �jfj wy •a
Site Plan Name: ADAMS HOMES
Lot No.�
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
— X Windows/Doors
Electric Plumbing _ Sprinklers _ Generator Roof
Pitch
Total Sq. Ft of Construction: 2 `ja(j Sq. Ft. of First Floor: _ 6r,13
Cost of Construction: $ �Dc�,'-lU(� 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: AUAMS 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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 at more, a RECORDED Notice of Commencement is required.
9
DESI
ENGINEER:
Name: Keesee As"soci.les
Address:
City: Apopka
Zip: 32703
945 South Orange Blossom Trail
— Not Applicable
Phone 407.080-2333
FEt SIMPLE TITLE HOLDER:
Name:
Address:
City:
'Zip: Phone:
—
State: FL
— Not Applicable
MORTGAGE- COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
ZiP Phone:
Not Applicable
State:
_Not Applicable
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
STATE OF FLORIDA
COUNTY OF SainLLucie
The forgoing instrument was acknowledged before me
this _L4L day of 207_L by
� yo
Name o40qr-n;-,, kng statement.
Personally Known x OR Produced Identification
Type of Identification
Produced_ U ON V 1
(Signature of Notary Public- State of Florida )
Commission No.
Notary Pubhc State
Hannah E Moore
REVIEWS FRONT Z016"
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
I ExPtres 07r01/2o2d
ture of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this 11, day of —, z p2f by
A - bu n f
Name of p sre on making statement.
Personally Known x OR Produced Identification.
Type of Identification
Produced Y_ Y) OW i,_S
:Hk� ► t W v u
(Signature of Notary Public- State of Florida )
nNo. lg
VEGETATION
REVIEW REVIEW I REVIEW
(Seal)
KPIres P710KIN?}EW