HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� '�� Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: SFR
PROPOSED IMPROVEMENT LOCATION:
RECENV' a
Building Permit Application
APR 3 0 2021
T. LuoieomL, Perritins�
Commercial Residential x
Address: 9413 Potomac Dr
Property Tax ID #: 2327-502-0021-000-4 Lot No.
13
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: 1
Garage Swing: L
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: 2,.-�� Z Sq. Ft.:of First Floor..
Cost of Construction: $ ' 1i �o , S� t) 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
City: Palm Bay State: FL
Address: 1430 Culver Dr NE.
Zip Code: 32907. Fax:
City: Palm Bay State: FL
Phone No._321-733-2111
Zip Code: 32907 Fax:
E-Mail: Melboumeaermitting(D-drhorton.com
Phone Nb M-733-2111
Fill in fee simple. Title Holder on next page ( if different
E-Mail Melboumepermitting@drhorton.com
from the Owner listed above)
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 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:. Stater
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 permitto 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,beforeme
this 5 day of APRIL 021 by this-.5—day of :. APRIL , 2021by
Brian W. Davidson Brian W. Davidson
F -5
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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. Pu
(Signature of Notary Publi
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