HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSAll APPLlr'4dLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
cote: Iy Per ' Number:
RECEIVED
AUG 14 ?019
------------ Builc�i"ng Permit Applicatio
Planning and Development Services ST, Lucle County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: New Construction -5-r,�
PROPOSEDIMPROVEMENT LOCATION: �iLS)8rslnn I
Property Tax ID MJ00a—(oDd'- 0378- OGIO— t7 Lot No. do
Site Plan Name: I^J Block No.J0
ProjectName:g[1l�Oj tit /y0(��[1 4, rImde. t—.
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
chanical GasTank _Gas Piping _Shutters
Electric ✓ZPluJmbbiing _Sprinklers _Generator
Total Sq. Ft of Construction:: ►T1 ^
V
Cost of Construction: $ 1' Y,�LOls-b
Sq. Ft. of First Floor.
Utilities: Sewer _Septic
Windows/Doors
Roof Pitch
a61 o
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Adams Homes of Northwest Florida, Inc
Name:
Address:3000 Gulf Breeze Parkway
Company:Adams Homes of Northwest Florida, Inc.
City: Gulf Breeze State: _
Zip Code: 32563 Fax: 772-905-8511
Phone No.772-905-8394
Address:3000 Gulf Breeze Parkway
City: Gulf Breeze State: FL
Zip Code: 32563 Fax: 772-905-8511
Phone N0772- 905-8394
E-Mail: pslpermits@adamshomes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
o roc- 2 1 A�C�
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: _
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: of Applicable
N a m e: Keesee Associates
Name:
Address: g s south Orange Blossom Trail
Address:
City: Apnplos State: FL
City: State:
Zip: 32703 Phone407-880.2333
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name: 1
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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
igna re of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
CO U NTY 10 F Saint Lucie
COUNTY OF Saint Luse
The f r oing instru ent was acknowledg before me
thi day of 20 by
The fof,�Qing mstr ent was acknowledg before me
this jL� day c 20_ by
William Bryan Adams I
William Bryan Adams LJ
Name of person making statement.
Name of person making statement.
Personally lKnown x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
I
( 0
ltti �/
Signaturd of Notar bl?r-State-e
:s°''• : PATRICIA ANN GRIFFIN
Commission No. cct ie2a ••: MY COMMISSflgN # GG137824
EXPIRES September 26, 2021':?;?.�;,,�'
(Signature of Notary ;b'�Iq Sfa
ri �f�@ bNN GRIFFIN
ccta s a '= MY COMMI 10 # GG137624
Commission No.. ' :.• SS a
XPIRESepte ber 26, 2021
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