HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: NOPermit, Number: `0� �4'drJ1l
SCANNED
BYCOCT2
—_ St. Lucie Cou
Building Permit ApplicaPlanning and Development ServicesBuilding and Code Regulation Division
2300 VirginiaAvenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: �
Address:
Property Tax ID #: y&-
Site Plan Name: Lot No.
Additi al work to be performed -under this permit — check all that apply:;
Mechanical Gas Tank Gas Piping
— P g —Shutters Windows/Doors
_Electric ✓Plumbing —Sprinklers Generator
• ✓Roof Pitch
Total Sq. Ft of Construction: aU�� LISAOZ
Sq. Ft.
�of First; Floor:
Cost of Construction: $'2 &5Z ,� Utilities: ✓Sewer _Septic Building Height:
NameAdams Homes of Northwest Florida, Inc. t'
Name: Willia 'B an Adams - Qualifier
AddCity: Gult uuuHre Gulf Breeze Parkway P y,Adiahr � Homes of Northwest Florida, Inc.
Gulf Breeze Com an
City: State: _ Address: 3000 Gulf Breeze Parkway
Zip Code: 32563 Fax: 772-905,8511 Gulf Breeze City: Phone No.772-905-8394 State: FL32563'
zip Code:
E-Mail: Pslpermits@adamshomes.com Phone No 772-90— 5I Fax:
Fill in fee simple Title Holder on next page ( if different E-Mail Pslperrnits(c—oadamshomes.com
from the Owner listed above) State or County License CRC1330146
If value of construction is $2500 or more, a RECORDED Notice of Commence -
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is
Name: Kassee ASspplates Arp heWwe Design, Planning ' v
Address: 945 South Orange Blpssom Trail
City: Apopka
State: FL
Zip: 32703 Phone407S80_2304
rtt -NIMPLE TITLE HOLDER: of Applicable
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY: NotApplicable
Address:
City: State:
ZIP Phone:_
BONDING COMPANY: Not Applicable
Name:
Address:
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.
which is nocontlimakes
with any applicablelHothat
e Owis ners Asssocil permit lesll abylaws or and covenantshorize the permit thatmabuild
y 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, walks,
-signs, screen roomsiand 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 AOwner Signature of
STATE OF FLORI
COUNTY OF�jn�G �iCll
The forgoing instrument was acknowledge before me
thisoday ofG�'.:{D�S� 20/by
Name or person making statement.
v OR Produced Identification
of Notary Public -State of
STATE OF FLO DA
COUNTY OFLJQyy
The for oing instru en w s acknowledged before me
thi//s day of ��/K"f� I/ , 200.//V�� /by
//AIll ✓H rIYL4 4
Name of person makin statement.
Commission N �i��lto? p!""` IrATRICIA ANN RIFFIP
!'?r0INY COMMISSION # §gB781L
EXPIRES Septembe 26, 2021
REVIEWS I FRONT I ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW I REVIEW
/***' OR Produced Identification
Notary Public -State of Florida
VEGETATION SEATURTI
REVIEW REVIEW
TRICIA ANN
COMMISSION #
REVIEW
2021