HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T_y�\ •�(-
Permit Number:
SCANNED (D3e EREBY
St. Lucie Cou Planning and Development Services.lilding Permit Application
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commerc; I
PERMIT TYPE:
Address:
Property Tax ID #:
la Residential X
Site Plan Name: _ v Lot No.13
• 1-11 y -di worx to be performed under this permit —check all that apply:
—Mechanical y'
Gas Tank pp_ Gas Piping _ Sh'utkers
Electric �l1.umbin
kl
r^g I — Spriners _ GF neratdr
Total Sq. Ft of Construction: ;U-1I
indows/Doors
— ^ate' Pitch
Cost of Construction: Sq. Ft,/of�FirstiFlcior: *-
� 9y V c Utilities: —V Sewer , Septic Building Height:
Ont7ia',b : l.: E:ijgr aM1
NameAdams Homes of Northwest Florida, Inc.
Address:3000 Gulf Breeze Parkway Name:VVilliari 'B an Adams -Qualifier
City: Gulf Breeze Company:Adams Homes of Northwest Florid
32563 State: _
Zip Code: — Fax:772-905-85.11
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)
3000 Gulf Breeze
City: Gulf
Zip Code:
Phone No
Inc.
Kway,
State: FL
Fax:
E-Mail Psiperrnits;@adamshomes.com
State or County I!icense CRC1330146
-- value or construction is $2.500 or more, a RECORDED Notice of Commenceme
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is rf
a.�atuiv�n�crv�IrvttR: _Not Applicable
N a m e: Keesee Aeeeelaiea Architecture Design, Planning
Address: 945 South Orange Blossom Trail
City: Apopka
State: FL
Zip: a27o8 Phone407-880-2304
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
City:
Zip:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip Phone:
BONDING COMPANY: _Not Applicable
Address:
Zip:
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.
which Is in contlitcnt makes
any applicable iHo a Owthat is ners Associationranting a permit
les abylaws or andpcovenants that build
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 wifl, 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 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 W—TDDV41
WITH YAI.IB LENDER OR AN ATTORNEY BEFORE RECORD G YIdQ OIIR NnTIAP nv-rnli�u�A^N FINANCING, CONSULT
r7
as Agent for Owner
STATE OF FLORI
COUNTY OF ` aC f
The fo oing instrume t as acknowledge efore me
t,isp day of 201I by
4L-li� li ., 80` OR Produced Identification
Type of Identification
(Signature of Notary Public- State of Florida )
Commission
MY COMMISSION # GG137624
Signature o /License Holder
STATE OF FLORIDA .
COUNTYOF
The fo�$ping instr en Nlas acknowledged before me
this oi/ day of t/ �] J �20_ by
I r ALA/
Name of person makin4fstatement.
Kno OR Produced identification
ntificatinn
��(Signature ofNotary to of Florida
Coms's1n�So 7 �A PATR CI 1ANN GRIFFIN
:f 9:
5 MY CO �SION N OG137624
?o. EXPIRES September 26, 2021
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