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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: alslof - 0559
go R RECEIVED
Building Permit Application
Planning and Development Services JpN
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
St. Luciea CCounounty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: SFR
PROPOSED IMPROVEMENT LOCATION
Address: 9213 Potomac Drive I
PropertyTax ID #: Tl3t' Lot No. 62
Site Plan Name: Creekside Plat #4 Block No.
#1 Project Name: r`
DETAILED DESCRIPTION 'OF WORK:
Construction of a new single-family residence
# of Bedrooms: 4 # of Bathrooms: 2 # of Garages: 2
Garage swing: RIGHT
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
X Mechanical _Gas Tank Gas Piping _Shutters X Windows/Doors
X Electric X Plumbing Sprinklers _Generator X Roof Pitch
Total Sq. Ft of Construction: 2362 Sq. Ft. of First Floor: 1828
Cost of Construction: $ 100,540 Utilities: X Sewer —Septic Building Height:
OWNER/LESSEE:`
CONTRACTOR:
Name DR Horton Inc
Name: Brian W. Davidson
Address: 1430 Culver Dr NE
Company: DR Horton Inc
Address: 1430 Culver Dr NE
City: Palm Bay State: FL
City: Palm Bay State: FL
Zip Code: 32907 Fax:
Phone No. 321-733-2111
Zip Code: 32907 Fax:
E-Mail: Melbournepermitting(aDdrhorton.com
Phone No 321-733-2111
Fill in fee simple Title Holder on next page ( if different
E-Mail Melbournepermitting@drhorton.com
State or County License CRC1327068
from the Owner listed above) q 5q
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.
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A
,SUPPL'EMENTAL°CONSTRUCTION, LIEN LAWW INFORMATION
DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name: AB Design Group Inc
Name:
Address: 551 S Apollo Blvd.
Address:
City: Melbourne State: FL
City:
State:
Zip:32901 Phone:321-237-0436
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY:
X Not Applicable
Name:
Name:
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
"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
WITH YOUR LENDERORANATOTORN YBEFORERECORDINGOYO RNOTICEOBFTCOMMENCEMRCONSULT
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 6 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.
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Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Pu t�Qi�lc3r,�da,!
;•q.D1NA PARRIPlO
Commission No.MY00,
SegtAPARRINO
Commission No. INN#FF957800
MY COMMISSION # FF 957600
; • �` EXPIR�S: February 27, 2020
= EXPIRES: Februa 27 2020
Bonded 7hru Notary Public Untlenvriters
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