HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION/TO BE ACCEPTED / Date: SCANNED Permit Number: 1"I�IJ '�/L�o(�
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BY
St. Lucie Countv
D
— — —~ Building Permit Application
Planning and Development Services
Building and Code Regulation Division �3 '� FO
2300 Virginia Avenue, Fort Pierce FL 34982 c�4
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential �r
PERMIT TYPE: New Construction
PROPOSED IMPROVEMENT LOCATION:
Address: .S f ei r
Property Tax ID #: 3gbg —& to- Odsz — lm — 3 Lot No. 0.s�
Site Plan Name: /�,�/,, Block No. :Z
Project Name: i cbJ�fti-r �%td of 0Ak DJ2d t F&n da wit
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additignal work to be performed under this permit — check all that apply:
✓chanical _�GasTank _Gas Piping _Shutters Windows/Doors
_ Electric ✓Plumbing _ Sprinklers _ Generator &--Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $o!�%TM
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic 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 No772- 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 CRC1 330146
n vame or construction is>Aouu or more, a ittcuRDtu Notice of commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
,y
EER: _ Not Ap
Name' Keesee Assodaras
Address: 945 South Orange Blossom Trall
City: Awoke State: FL
Zip: 32703 Phone 407-880.2333
MORTGAGE COMPANY: _CNot Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: —ANot Applicable BONDING COMPANY:
Name: Name:
Address: Address:
City: Cit
Zip: Phone: Zip
Phone:
Applicable
UVVivtK/ LUN 1 KALI UK AIFtIUVI-I: 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 RFFnBF RFrnorniur Ynnn iunTirr nc remurNrEmcmv -
Signatu Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saintt.uoie
COUNTY OFSaintwue
The for oing instrument was acknowledged before me
this 2dayof�," AL." by
The forgoing instrument was acknowledge before me
this
.20,&
_adayof ,201L by
William Bryan Adams
William Bryan Adams
Name of person making statement.
Name of person making statement.
Identification
P�Know OR Prod�PATRI
Personally Know OR Produced Identification
Produced %�a•. NGRIFFIN
F�oduceldentification
•"":; • RICIA ANN GRIFFIN
'•= MY COMMt£=:-7N # GG1376241
- " # GG13762
•",±• EXPIRES September 26, 2021
_ . MY COMMISSION
'�aq•.. EXPIRES September 26, 202t
'... ,•`
(Signature of Notary Publ - ate of Florida)
(Signature of Notary Public- tate of Florida )
Commission No. GG137624 (Seal)
Commission No. GG137624 (Seal)
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