HomeMy WebLinkAboutBuiding 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) 462-1553 Fax: (772) 462-1578
Permit Number: _55o, _ In e
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Building Permit Applicationuaw:pedaa 6up1lwaad
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Commercial Residential X
PERMIT TYPE: NEW CONSTRUCTION
Address:
Property Tax ID fl: / 3 I % — (/y._
Lot No.
Site Plan Name: ADAMS HOMES
Project Name: ADAMS HOMES OF NORTHWEST FLORIDA, INC. Block No. _
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Additional work to be performed under this permit — check all that apply:
'6 Mechanical Gas Tank
�( Electric X Plumbing
Total Sq. Ft of Construction: 5,5' d
Cost of Construction: $ Lidy, LfD(o
_ Gas Piping _ Shutters _KWindows/Doors
Sprinklers _ Generator X_ Roof Pitch
Sq. Ft. of First Floor: ,2 �-
Utilities: V'_ Sewer _ Septic Building Height:
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)
Name: WILLIAM BRYAN ADAMS - QUALIFIER
Company: ADAMS HOMES OF NORTHWEST FLORIDA INC.
Address: 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
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.
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.
ucie
untv makes no
on
which is noconfli t with any applicable iHomethat
Oiwners As�ociation irules, authorize
or andpermit
covenants that mays thesubject
olrprstructure
oh bit 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
in accordance with the approved plans, the Florida Bu lding Codes and St. Luc etC 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 accessory uses to a th
no r
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTINnon-residential
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 Saintl-ucie
The forgoing instrument was acknowledged before me
this lip day of/►'N FO�rr 202-
_1 by
QI11�(
Name of p6rson making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced Know h
(Signature of Notary Public- StateCda )
Commission No. a- D9-q rrh,r
Notary Puphc stela
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 SaintLucie
The forgoing instrument was acknowledged before me
this �rQ day of�'-d, 20Z_[ by
►�f
Name of person making statement..
Personally Known x OR Produced Identification
Type of Identification
Produced 1, Y)0w ('-S
W, Y 1 WOAJ
(Signature of Notary Public- State of Florida )
n No. -( I (Seal)
VEGETATION Z M11
on
REVIEW REVIEW ytEzpires