HomeMy WebLinkAboutBuilding Permit Applicationi 7
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D� �' a�217 Permit Nui
Building Permit Appl
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: SFR
PROPOSED IMPROVEMENT LOCATION:
u ".
:ion FEB 4 2020
Permitting Departmer
St. Lucie County, FL
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Address: 9224 Potomac Dr fl
PropertyTax ID #: TBD �a� a%'Sn�—in) � I -On lJ c� Lot No. 103
Site Plan Name: Creekside Plat #4 Block No.
#1 Project Name:
DETAILED DESCRIPTION OF WORK;
Construction of a new single-family residence
# of Bedrooms: 4 # of Bathrooms:2 # of Garages: 2
Garage Swing: LEFT
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
X Mechanical
X Electric
_Gas Tank
X Plumbing
Total Sq. Ft of Construction: 2442
_Gas Piping
_Sprinklers
_Shutters X Windows/Doors
_Generator - X Roof Pitch
Sq. Ft. of First Floor: 1916
Cost of Construction: $ 105,380 Utilities: X Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name DR Horton Inc
Name: Brian W. Davidson
Address: 1430 Culver or NE
Company: DR Horton Inc
City: Palm Bay State: FL
Zip Code: 32907 Fax:
Phone No. 321-733-2111
E-Mail: Melbourneoermittina(d).drhorton.com
Address: 1430 Culver or NE
City: Palm Bay State: FL
Zip Code: 32907 Fax:
Phone No321-733-2111
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Melbournepermitting@drhorton.com
State or County License CRC1327068
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.
� �ln"133
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name: AB Design Group Inc
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 551 S Apollo Blvd,
Address:
City: Melbourne State: FL
Zip: 32901 Phone:321-237-0436
City:
Zip: Phone:
State: —
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY:
Name:
X Not Applicable
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
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF BREVARD
COUNTY OF BREVARD
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of JanUary 2020 by
this 6 day of January , 2020by
Brian W. Davidson
Brian W. Davidson
Name of person making statement.
Name of person making statement.
Personally Known __Y/_ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
'
(SignaLre%gAW_-FMbIr i lori
(Signature oc- tom 1•NY
COA�Comm:_ „ .c�r,niary 272020(S �I)
Commission'°
Banded Thru Nolery Public Underxrdete
Bonded N olxry Public UnS��
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