HomeMy WebLinkAboutBuilding Permit Applicationyam,
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: 5- O L .
Date:
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Building. Permit Applicatiop *4 LFo
Planning and Development Servicesi;
Building and Code Regulation Division <`c9pPb. 011
2300 Virginia Avenue, Fort Pierce FL34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential �04 t '%e
PERMIT TYPE: SFR
PROPOSED IMPROVEMENT LOCATION:
Address: 9620 Potomac DR
Property Tax ID #: 2327-502-0128-000-4
Lot No. 120
Site Plan Name: Creekside Plat#4 Block. No.
#1 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
X Electric
Gas Tank
X Plumbing
Total Sq. Ft of Construction: 2287
Cost of Construction: $ 96,580
Gas Piping _Shutters X Windows/Doors
_Sprinklers _Generator X Roof Pitch
Sq. Ft. of First Floor: 1756
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: Melboumeoermittino(cbdrhorton.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.
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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: Ud
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
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature ofContractor/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
7—day
this y day of APRIL zc�by
this of APRIL 2021 by
Brian W. Davidson
Brian W. Davidson
Name of person making statement.
Name of person making statement.
V
V
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Publi ,
(Signature of Notary Pu is
DINAPARMNO
ai9Mrry DINAPWINO
:.; AiY COM nq GG 935643
Commission No. 'if p;:��
EXPIRE
.: MY Co N GG 935643
Commission No. =.
:Februa 27,2024
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW,
REVIEW
DATE
RECEIVED
DATE
COMPLETED