HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE. INFO MUST BE COMPLETED'FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:,::2 Q-(X)
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Building Permit Applia tion MAY 7 2020
Planning and Development Services
Building and Code Regulation Division Perrnit-ting b, e p zi rl-.' i-n e n t
2300 Virginia Avenue, Fort Pierce. FL 34982 St. Luci& COU11ty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Cdmmercial Residentia]—X—
PE RMITTYPE: New Construction
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'CON CTPQ��,i"'[NFOT-�, ',T W,
Additional work to be performed under this permit- check all that apply:
)Mechanical —Gas Tank Gas Piping —Shutters Windo'ws/Doors
Electric X.Plumbing Sprinklers Generator A Roof Pitch
Total Sq. Ft of Construction:. Sq. Ft. of First Floor:
Cost of Construction: $ all a (i 1 Utilities: )L sewer — septic Building Height:
OWNER/LESSEE
,,.CONTRACTORName
Adams Homes of Northwest Florida, Inc.
Name: William Bryan Adams
Address:3000 Gulf Breeze Parkway
Company: Adams Homes of Northwest Florida, Inc.
Address: 3000 Gulf Breeze Parkway
City: Gulf Breeze. State:
Zip Code: 32563 Fax:
City: Gulf Breeze State: FL
Phone No.772-905r8394
Zip Code: 32563 Fax: 772-905-8511
E-Mail: psipermits@adamshomes.com
Phone N0772-9 05-8394
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 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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S'URPLEMENTAL CONSTRUCTION LIEN LAM LINFORMATION
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Keesee Associates
Name:
Add ress: 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 BFFnRF RFrnRntNr. Ynun iunTirF nF rnmmF;PirFMF1UT "
Signature of Owner/ Lessee/Contractor as Agent for Owner
—Si—g—na—t—u-re--oTTontrac—tor/Uicense—*Nolder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF saint Lucie
The,for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of ftyiL 20a Q by
this _. day of fqD Y l L- 20JD by
ry n n Ig d G
a N V(d a vY'S
Namd 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 o Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Commission No. GG137624 <°'aV•,L<±�,�;(q@A)rRICIAANN GR
11OK iission No. GG137624 (Seal)
My COMMISSION # Ot3
_
137624
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DATE
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DATE
COMPLETED
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2021