HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:A103 '6o,q
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Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: SFR
PROPOSED IMPROVEMENT LOCATION:
X
Address: 9504 Potomac Dr
Property Tax ID #: 2327-502-0124-000-6
Lot No.? 1 6
Site Plan Name: Creekside Plat #4 Block No.
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
New Electrical Meter Second Electrical Meter
CONSTRUCTION JNFORMATIOW
Additional work to be performed under this permit — check all that apply:
X Mechanical Gas Tank Gas Piping Shutters X Windows/Doors _ Pond
X Electric X Plumbing Sprinklers Generator X Roof Pitch
Total Sq. Ft of Construction: 2442 Sq. Ft. of First Floor: 1916
Cost of Construction: $ 134,310 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
Zip Code: _32907 Fax:
Phone No._321-733-2111
E-Mail: MelbournepermiftinoCaDDRHorton.com
City: _Palm Bay State: FL
Zip Code: 32907 Fax:
Phone No 321-733-2111
E-Mail MelbournepermittingCcDDRHorton.com
State or County License CRC1327068
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: AB Design Group Inc. /Michael Anderson
Address: 2194 HWYAIA#301
City: Indian Harbor Beach State: FL
Zip: 32937 Phone 321-237-0436
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
x Not Applicable
MORTGAGE COMPANY
Name:
Address:
City:
Zip: Phone:,
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
State:
x Not Applicable
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recordine vour Notice of Commencement.
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
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 4 day of March 2021 by
this 4 day of March 2021 by
Brian W Davidson
Brian W Davidson
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced_
(Signature of Notary Public-' , ' iNo
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