HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f-1
Date: �.� 1 , I "l 1 f' O0J 1
PermitI Number: _
SCANNED
BY RECEIVED St. Lucie CounhNOVA 4 7,01q
Building Permit Application Permitting Department
Planning and Development. Services St. Lucie County
Building and Code Regulotidri Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential X
PERMIT TYPE: V I n
Address:
Property Tax ID q:
Site Plan Name:
Additional work to be perform
1/11
under this permit - check all that apply:.
_ echanlcal Gas Tank I�nI0i ry has Pipi;n % _Shutt-�
Electric ✓ Plufnbing i j S • lers
Z rilLci VA (riyp',; PfM,L W _ Gi1nerator
Total Sq. Ft of Construction: I
Sq. Ft. of First;Floo'r: _
Cost of Construction: $ a2Ca1 (�
l� `� Utilities: Sewer , 5epl
Lot No. -' t
Block No. LHA
Windows/Door,
Z�O� CT,1�-tC1 staGl��!
Roof _ t Pitch
Building Height:
�.»wwaancerns�4r.sifia flR; `"^"- van .
NameAdams Homes of Northwest Florida, loc.
Name: Willial 8 an Adams -Qualifier ^-
Address:3000 Gulf Breeze Parkway p
a; Inc
lor
Company:Adams, Homes of Northwest Fid.
City: Gulf Breeze ._• ,
State:_ Address: 3030Gut(Breeze ParkvMgZ"1-.Cs\�
Zip Code: 32563 Fad''(�� kil }
� � •• C city:Gulfbreeze �
Phone No. 772-905-8394 State: FL
Zip Code: 32563 1 Fax:
E-Mail: Pslpermits@adamshomes.com
Fill in fee simple Title
Phone No 772-917,5-8394
Holder on next page ( if different E-MailPslperMits(6adamshomes.com
from the Owner listed above)
State or Courity Ll6ense 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
I
i
Name: Kee:aeA:.aaa,¢yArphi,ac,ureoesign.Fiannina
MORTGAGE COMPANY —
� Not Applicable
Address: 945 Savlh Orange B105,0M Trail
Name:
City: Apopka
State: rL
Address:
City:
Zi p' Phone 407-980.2306
State:_
Zip:
Phone: —
FEE SIMPLE TITLE HOLDER: Not Applicable
_
Name:
BONDING COMPANY: Not Applicable
Address:
Name:
City:
Address:
Zip: Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby4 t`a- Ejtcrobiai S 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 pgrrr+i[ holderYo`build+Nesubject`st'ructure
which is in conflict with any applicable Home Owners Assocation rules, bylaws or and coJdriants that may rilie su or prohibit such
structure. Please consul[ with your Home Owners Association and review your deed for @ny�s
\Srictj�n�Whic�i.,Qjatl'O pyly Inconsideration of the granting of this requested permit, I do hereby agree'tha't�l�t�iill, in all respects, perform the work
in accords ,&e with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The followilltonc
nig building permit applications are exempt from undergging,a,fuLure nc vevl@ � ripp, aY'f�djtk?n�g"t4i'+ra.
accessoryrstructures, swimming pools, fences, walls, sigrLii 6c jeek,VbI6A and'PeA' or�uyssees"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 RFf nnnrar vnn�..+..r...� .... ___ _
•--• .,..,�r LcbbeeiLontractoras Agent for Owner
STATE OF FLO
COUNTYOFM;qD{ &IC10
The for oing instrument was ackn I d
STATE OF FLORI
COUNTY OF S)'NM lam i
owe ged before me The for oing instrumen was acknowledged before me
this day of PP
20g by this e7.7 day of j��F! 20J9 by
Name of personmaki gStatemd�
Name of person making sty aternent.
LEIrson ow OR Produced IdentlficatlQn ` �:•.
T ersonally Known ype of Identification OR'P o eted�rc�ehtification
Produced Type oFldentif, ion
(Signature of Notary public- State of Florida )
(Signature of Notary Public- State of Florida )
Commission No PATWQJ t ANN GRIFFIN
'`- MY COMMISSION # GG137824 Commission N �( `fie;; PQed,�ICIA ANN
c tember 26, 2021 _ ,r, MY CpprMMISSION a
%9f '?'<'ow.c EXPIRES Septembc
REVIEWS FRO SUPERVISOR I PLANS VEGETATION SEA TURTLE COUNTER REVI W REVIEW REVIEW REVIEW
MANGRO%
DATE _ REVIEW REVIEW