HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578
Permit Number: — 6 / 2
Building Permit Application
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Commercial . Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address: �)g5-d LL a
Property Tax ID #: 13 // — 766-- "),0yo r 0()6
Lot No. a -
Site Plan Name: ADAMS HOMES
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
-P Electric Plumbing _ Sprinklers
Total Sq. Ft of Construction: U q
Cost of Construction: Utilities
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)
XWindows/Doors
Generator K_ Roof Pitch
Sq. Ft. of First Floor: % i7d to
: ./Sewer _Septic Building Height:_
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
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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I certify that no y work or installation has commenced prior to the issuance of anperrmitmit to do the work and installation as indicated.
es no
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which cis inocontflic with any applicableiHomeaOiwners Associationranting a irulesill authorize
by bylaws or andthe pcovenantsthat maiydrestri t ofrprstructure
ohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the grantin of th'
g is 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 Signature of Contractor/License Holder
STATE OF FLORIDA COUNTY OF saintSTATE OF FLORIDA
�ucle COUNTY OF SaiolLucfe
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20LL by this —a— day of 20 Ll by
Q�. �ryan �� s Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x
Type of Identification OR Produced Identification
Produced- K h w V 1 Type of Identification —
Produced K h ow r,,&
.LLuLlIw ju IV yl l' u (Signature of Notary Public- State of Florida )
(Signature of Notary Public -State of Florida )
Commission No. 11 l ID -q— q
p NoWryPu0hc3oa� omm s n No. (Seal)
Hannah E Moore
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7a P.Erpues 07i01rZpp o
REVIEWS FRONT ZO VEGETATION � na Moore
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE �Kpues 710}EW
RECEIVED
DATE
COMPLETED
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