HomeMy WebLinkAboutBuilding Permit ApplicationI I N
AII'APPLICABLE:INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
-CEVED
Building Permit Application EEB o3
Z010
Planning and Development Services Pe , d c eC9 rl nt
Building and Code Regulation Division St.
2300 Virginia Avenue, Fort -Pierce FL 34982
Phone: (772) 462=1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT -TYPE: New Construction
:PROPO$,EDIMPROVEME.NT LOCATION,'
Address: 8120 FtMq 1 f' I CAY
Property Tax ID #: _ 13 I - "T 00 - 0132 — 000 I Lot No. 2S
Site Plan Name: dam S H Om eS Block'No. 2
Project Name.: Adorns I brr"'2s OF NOr+hw f F10r06 NO-.
CONSTRUCTION INrFORMATIQN
Additional work to be performed under this permit -check all that apply:
x Mechanical _ Gas Tank _ Gas Piping _ Shutters
Y Electric Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ g `l�zly Utilities: x Sewer _Septic
-C Windows/Doors
X Roof Pitch
Building Height:
OWNER/LESSEE
C, 'TRA&' -
Name Adams Homes of Northwest Florida, Inc.
Name: William Bryan Adams
Company: Adams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze,Parkway
City: Gulf Breeze State: _ .
Zip Code: 32563,. Fax:
Phone No. 772-905-8394
E-Mail: pslpermits@adamshomes.com
A'ddress:3000 Gulf Breeze Parkway
City.. Gulf.Breeze State: FL
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)
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 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION >�
x h r
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not
_ ppLicable
Applicable
Name: Keesee Associates
Name:
Address: 945 South Orange Blossom Trail
Address:
City: Apopka State: FL
City: State:
Zip: 32703 Phone407-880-2333
;i
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."
Si of Owner/ Lessee/Contractor as Agent for Owner
Signature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OF saint Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by,
this day of 20_ by
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 P 'c- State of Florida)
(Signature of Notary Public- t o,� Flor
GG137_' PATRIA�NN GRIFFIN
=s `;: RICIA ANN GRIF
t' :�: MY(��ISSION
Commission No. ;= eal
Y coM IS ION # GG137624
Commission No. GG137sza =� G137
# G
2
gj&CF F`p� EXPIRES September 26 2021
l
oFvC?:�' EXPIRES September26, 20
1
REVIEWS
FRONT
ZONING
SUPERVISO
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
L