HomeMy WebLinkAboutBuilding Permit Application Ail APPI_f�'ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: n,2,)) c
.2
Building Permit Applicaiion MAY 72020
Planning and Development Services pe�' -,
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Jitcnt'-
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ResijWn-fi-M-
Y, FL
-PERMITTYPE: New Construction
IP RO POSED1VEMENT"
LOCATION
Address: 53Y UJOIYO R
Property Tax ID#: 1311- 10 1- 0 0 5D r 000- 5 Lot No. I
Site Plan Narne:- nf)o mi mmkj Block No._5
Project Name: -Ma N ovit F C
Bat" T 0 0 M'S GA COY QCAYQQ 'f
CO.,NSTRUCTIQN INFORMATION:,.
Additional work to be performed under this permit—check all that apply:
Mechanical Gas Tank Gas Piping Shutters Windows/Doors
K Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1 2 D
Cost of Construction: $ q D Utilities: Sewer Septic Building Height:
0 CONTRACTOR
lt/LESSA':' ,:.
WRE
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
Phone No.772-905-8394 Zip Code: 32563 Fax: 772-905-8511
E-Mail:psipermits@adamshomes.com Phone No772-905-8394
Fill in fee simple Title Holder on next page if different E-Mail ps[permits@adamshomes.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.
,
SUPPLEMENTAL CONSTRUCTION LIEN LAW, INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Keesee Associates Name:
Address: 945 South orange Blossom Trail 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."
l 4giure
i nnature of Owner/Lessee/Contractor as Agent for Owner n OfContractorLicense/ Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SaintLude COUNTY OF SaintLucie
The f oing instrument was acknowledged before me The f oing instrument was acknowledged before me
this day of P'P V 1 L.. 20aO by this day of ft D Y k L_ 20a Q by
n n n-a a ms E)YN CA N G MS.
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State o a _
;iP« ego, PATRIClQ+Aid Qi �tr of Notary P is r e p i
,=a- 4�, t° " IA ANN GRIF9-9N
Commission No. =t- Sl; MY COMMISSION GG137624 ?
cG13762a .( GG1376 4:N- •,3 .S� MY COMM@§IpN#GG137624
b"-='�¢= EXPIRES Sept QSI ,1 n No. q
' OFFL�� I';�oFFttir EXPIRES September 26,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19