HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Date: TO BE ACCEPTEb
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:. Permit Number::.
:Building Perini#Application RECEIVED
Planning and bevelopment Services
Building and Code Regulation_Divislon JUN 0 ;9 2017
.2300 Virginia Avenue, Fort Piece FL.34982 .
Phone: (772) 4624553 Fax:, (772) 462=1578 con1n1@ 'CIi31 PE
RMITTING
fTIr�G
R@Sldetl3iayucil+ County; FL
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PERMIT APPLICATION FOR:
Building
PRO,POSEDaMPROVEMENT10GATI6N: .
3�109 Yellowstone CIR � ' Address: -
Legal Description: Creekside Pint .Kin .1 Lot 118
.Property Tax _ 2326.- 600-0123000-7
:� _ ...
Slte Plan Name:
Lot No. 11i $
Project Name:.:: Block No.: .
Setbacks: Front Back: {p 2X 2� ��-
_ Right Side: Left Side:��
DETAILED DESCRIPTION"OF WORK:: `
Construction for new Single Family Residence
1 �3Z8►�
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CONSTRLfCTION.INFORMATION:.
i Iona wor to= . orme un er is permit — c ec a aPp
y: .
�HVAC
'GasTank aG�PI'ln �
` P g _Shutters: .
Z Ir.j Windows/Doors
Electric. _ Plumbing �SprinkJecs
Generator �✓ Roof
R. .
� Total Sq. Ft of Construction: y2. _ �. f� � � '
oof pitch
Cott.of Construction: $' 3 S offirs or:, L�
�•
�Ft:. t�
Utilities: Sewer Septic Buildingg :Hei ht:
:OWNER/LESSEE:
CONTRACTOR:
Name D.R. Horton _.... -
Name: Brian. Davidson
Address 1430 Culver Drive NE. ..
City: Palm Bay FL Address:
Horton
Zip.Code: 32907 State: ` Address: 1430 Culver Drive NE
Fax:321=733-7092 City: Palm_ Bay..:
Plione:N6. 321-733-2111 State: FL
Zip Code: 32907 : E-Mail: Melboumepeuii(ting@DRHorton.com Fax: 321-733-7092•
Phone N:o. 321-733-2111
FIII in,fee simple Title Holder on. next page If different . E-Mail: p
... .
p 8 ( Melbourne ermitting@DRHorton_cddi from the 0 iiner listed above)'
State or County.License: CRC1327068 ....
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required..
SUPPLEMENTAL CONSTRUCTIONI ENIAW INFORMATION:
DESIGNER ENGINEER:
Name: Aa l)eatgn Gmup Ine. ---=Not Applicable' MORTGAGE COMPANY:
Addres 141 N.,Ronald Roapen 1314. Name-- Not Applicable..
City: 'ier,gwood Address:
Zip: azrso . .. Phone: aor:aa-gms: State: FL
City:
:ZIP' Phone: —
State:
FEE.SIMPLE
TITLE HOLDER: ; Not Applicable
80ND1NG COMPANY;
Name: Not Applicable:
Address: Name:
City' Y Address:
Zip: City:
Phone-
.. Zip:
---_ Phone:
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 autoorize the. permit holder
which is in conflict with Any applicable Home Owners Association rules, bylaws, oc and covenants that ma
structure. Please consult with your Home Owners ersAssocin and review your deed for. cove restrictions which ma apply.
to build the subject structure.
In consideration of the granting of this requested permit, I do hereb agree that i will, in all respects, Y restrict or prohibitsucfi
In accordance. with.the a p y g y
approved laps tfie Florida Building Codes and St. Lucie I will,
. p cis, perform the work
The foUowing building permit applications are exempt from undergoing afull-concurrency review: additions
accessory structures, swimrping pools, fences, wails,.sighs; screen rooms and. accessory uses to another non=resi
WARNING TO OWNER: Vour fallu�e:tto Record a Notice of Commenceme ,
improvements to your prope 'residential use,
before the first inspection,. if you intendto-obtain:financing, consult with lender It in yourpayingh6jo for
property. A Notice of Commencement must.be recorded -and posted on the j il'for
commbSito
erlc(n work or recordingour Notice of Commencement.
or an attorney before
Signature of Owner/Lessee/Contractor as
Agent for Owner Si nature of ontra.ctor/License Holder S STATE OF FLORIDA
COUNTY OF.Bmar'd STATE OF FLORIDA
COUNTY OFBw-d
The fo oing instrument was acknowledged before me The forgoing.instrt- ment was acknowledged. before
this. day of June....:. 20 17 b
-- Y this .7 day of June
L/ me
em �0 1 by
(Name of person acknowtedgIng ).Gf c�dl�- �-Pd xtZ
(Name of person acknowled in
(Signature,o otary public- State of Florida)
�y (Signature of Notary
Personally Known :Public - State of.Florida )
. OR Produced Identification
Type of Identificat_ion.Produced Personally Known �=
TYPe of Identification Prod ed roduced Identification
Commission No.
°e e otary Public State of FI An Sion. No:. . .
1v, Sandra Leone air i el�otary Public Stete of F da
q~ 251 ? Sandra Leone
j� or N ' -Expires 08110/2020 My Commisslon GG 0 1
Revised 07/15/2014
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