HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and De velopmen t Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578
Permit Number: �66 V" ey
RECEtVeo
ME�R � 510ti4.
Building Permit Application .Perstt%9Qe93 �1e�
Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address: 5 ,j/
Property Tax lD N: 1-311 Zn, -. as ll, 4 d 6&
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC.
Lot No.
Block No.
Additional work to be performed under this permit - check all that apply:
C� Mechanical _ Gas Tank _ Gas Piping Shutters
— X Windows/Doors
Electric Plumbing Sprinklers P _ Generator_ Roof Pitch
Total Sq. Ft of Construction: lniyd 9 Sq. Ft. of First Floor: /3?,J/7)
Cost of Construction: $ p�� c��p Utilities: Sewer _ Septic Building Height:
Name ADAMS HOMES OF NORTHWEST FLORID —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)
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 $7,50D or more, a RECORDED Notice of Commencement is required.
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 ra t' f L-
b n ing o t 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-r d I
es'
i en 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."
ature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Sail Lucie
The forgoing instrument was acknowledged before me
this 641-day of r , 20 ZZ by
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Know h
(Signature of Notary Public- State of Florida )
Commission No.
Notary Pubhc 8t01s
Hannah E Moore
REVIEWS I FRONT I ZO
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this,ff day of SAG 20,U—by
�. Man a m f
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Y-now im
(Signature of Notary Public- State of Florida )
n No. l I (Seal)
AW&A,4I VEGETATION
REVIEW REVIEW