HomeMy WebLinkAboutBuilding Permit Applicationr
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
INS
q W_
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349B2
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: ` ®�
Building Permit Application cP9oPb
Co d�
Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID 4: 7pa — — 6
Lot No. I Wq
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Additional work to be performed under this permit — check all that apply:
�v Mechanical —Gas Tank _ Gas Piping
Electric Plumbing _ Sprinklers
Total Sq. Ft of Construction: J61-4 I
Cost of Construction: $ Q?!2(_1L((o_ Utilitie
Name ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 3000 GULF BREEZE PARKWAY
City: GULF BREEZE
_
Zip Code: 32563 Fax: 772-905-8511 State:
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)
Block No.
Shutters K Windows/Doors
s:
— Generator K_ Roof Pitch
Sq. Ft. of First Floor: L-(�
1/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
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.
„ ---y it,dute w ooiain a permit to do the work and installation as indicated.
I certify that no y work or installation has commenced prior to the issuance of a permit.
makes no
whichisis nocontfli t with any applicableton Homeaoiwners Associationnting a iru esabylaws or andhe pcovenantsthat may estri t ojrproh bit 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 IN
in accordance with the approved plans, the Floequeste da Building Codes ces and St. Lued permit, I do hereby agreetC ulnl, inty AmlendmentsPerform the work
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 accessary uses to th
ano er 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 SaintLude
The forgoing instrument was acknowledged before me
this -0111 day of r� 202I by
Q Ill �1
Name of p6rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced_ LU W h
(Signaturle, RN o t Lar vy Public State of Florida )
Commission No. Dl ly�
Notary Public Stela
T4110� Hannah E Moore
REVIEWS I FRONT I ZO
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF SaintLu6e
The forgoing instrument was acknowledged before me
this day of ` , 20 Zj by
�buaffjawf
Name of p sre on making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced {- Yl OW IDS
�oo"
(Signature of Notary Public -State of Florida )
No. { 1 (Seal)
VEGETATION
REVIEW I REVIEW