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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater /'�Permit Number: .04 oJ__ 60 V i..
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Building Permit Applications Y
Planning and Development Services
Building and Code Regulation Division d o
2300 Virginia Avenue, Fort Pierce FL34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT TYPE: SFR
PROPOSED (MPROVEMENT, LOCATION: '
Address: 9304 Potomac.DR
Property Tax ID #: 2327-502-0114-000-3 Lot No. 106
Site Plan Name: Creekside Plat#4 Block No.
91 Project Name:
DETAILED DESCRIPTION OF WORK:
Construction of a new single-family residence
# of Bedrooms: 3 # 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: 2287 Sq. Ft. of First Floor: 1756
Cost of Construction: $ 96,580 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: MelboumepermittingCab-drhorton.com
Phone No 321-733-2111
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: 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..
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 followingbuilding permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen room's 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
FINANCING
WITHYOURLENDEROIRANATTTORNEYBEFORERECORDINGYOURNOTICEOFCOMME
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 in was acknowledged before me
The for�oing instrument was acknowledged before me
this 7 day of APRIL ��by
this —day of APRIL. 2021 by
Brian W. Davidson
Brian W. Davidson
Name of person making statement.
Name of person making statement.
Personally Known O.R Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
o______ _____
(Signature of Notary Publi
(Signature of Notary Pu 9 RIggirlp
„.B. � kb` DINAPARRINO
;.; MY COM nq GG 935643
Commission No. _ SI§��
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= MY CO N GG 935699
Commission No. EXPIf
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SUPERVISOR
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