HomeMy WebLinkAboutBuilding Permit Application! �f
ALL APPLICABLE INFO
, MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D!
Date: )� • �/ • Permit Number: '
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Building Permit Application DEC / 4 10V
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential X
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT,LOCATION:
Address:
Site Plan Name: CREEKSIDE
Block No.
Project Name:
Setbacks
Back: -I) k 0'-_-�' Right Side: 16 '44 Left Side:
I DETAILED DESCRIPTION OF WORK:
Construction for new Single Family Residence AiQf_-)E';N 191a , t &{.,,)—
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CONSTRUCTION INFORMATION:
Z
HVAC Gas Tank
b :d
..�_""z errrut— cnecK all apply:
Gas Piping Shutters
Q
Electric O plumbing
❑✓ Sprinklers
_
�Generato
Windows/Doors
r
Total Sq. Ft of construction: a5�iO o�Roof Roof pitch
_
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Cost of Construction:
$'� �S . Ft. of First Floor:
a' Utilities: ✓ Sewer p 2
�Se tic Building Height:
OWNER/LESSEt=�
Name D.R. Horton
Address: 1430 Culver Drive NE
City: Palm Bay
Zip Code: 32907 State: FL
Fax:321-733-7092
Phone No. 321_733.2111
E-Mail: Melboumepermitting@DRHorton.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Brian W. Davidson
Company: D.R. Horton
Address: 1430 Culver Drive NE
City: Palm Bay
ZIP Code: 32907 state: FL
Phone No. 321-733-2111 Fax: 321-733-7092
E-Mail: Meiboumepermitting@DRHorton.com
State -or Co". L' C
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is reEy cu required.
RC1327068
ed.
Ll
-;.. "F-nfr-M311tvCM: Not Applicable
Name: AS Design Group Inc.
Address: 1441 N. Ronald Reagan Blvd.
City: Longwood State: FL
Zip: 32750 Phone: 407.44.6078
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: —
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assocition 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an commencingwork or record(n our Notice of Corr—-- before
Signatu�ofwner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Brewwd
The forgoing instrument was acknowledged before me
this 30 dayof November 20 L7_by
(Name of person acknowledging )
I
(Signature o otary Public- State of Fl
�(orida )
Personally Known V \ OR Produced Identification
Type of Identification Produced
Commission No.
oti0` °Ls� Notary Public State of
Iwo I Sandra Leone
Revised 07/15/2014 ��°�°r m Expires oerawzo2o
Si nature of ontrac�torlUcenseHolde`r s
STATE OF FLORIDA
COUNTY OF Brevard
The forgoing instrument was acknowledged before me
this 30 �dayQof November Zl) 17 by
�J�Gc c�dli- ��evx-2.
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �— OR Produced Identification
Type of Identification Produced
REVIEWS FRONT ZONING I SUPERVISOR I PLANS
COUNTER REVIEW REVIEW REVIEW
eTG
INITIALS
T TY7 YlY'
No. a°trAv F4pal)Notary Public State of
415 _ Q Sandra Leone
o My Commission GG 0
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW I REVIEW