HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number: _I I 1&- o4up
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
DEC I t 'LO
Commercial Residential X .,, i NG
PERMIT APPLICATION FOR: FL
Building • `"
PROPOSED IMPROVEMENT LOCATION:
Address: Yellowstone Circle, Fort Pierce, FL y
Legal Description:
Property Tax ID #: 73ZG — (a o —
Lot No.
Site Plan Name:
Block No.
Project Name: 0 .�l �% � 1 9 r
Setbacks Front Back Right Side: J� Left Side:
DETAILED DESCRIPTION OF WOR .
Construction for new Single Family Residence ��{-�.G !��-� [�7
CONSTRUCTION INFORMATION:
1� FW1l K- NlecK an apply:
1 HVAC Gas Tank []Gas Piping _ Shutters10 1�
❑Windows/Doors
Electric � Plumbing` Sprinkler � Generator � Roof � Roof pitch
Total Sq. Ft of Construction: _ �►�(�— S , Ft, of First Floor: "f,
Cost of Construction: $ _ O . Utilities: R Sewer F]Se tic arid'
1
p u ing Height:
OWNER/LESSEE: CONTRACTOR:
Name D.R. HoName: rton Brian W. Davidson
Address:1430 Culver Drive NE D.R. Horton
Company:
City; Palm Bay State: FL Address: 1430 Culver Drive NE
Zip Code: 32907 Fax: 321-733-7092 City, Palm Bay
Phone No. 321-733-2111 State: FL
Zip Code: 32907 Fax: 321-733-7092
E-Mail: Melboumepermitting@DRHorton.com Phone No. 321-733-2111
Fill in fee simple Title Holder an 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
......v�.n0 F-tvu1lACCK: ____ Not Applicable
Name: ABOesionGmunina.
Address: 1441 N. Ronald Reagan Blvd.
City: Longwood State: FL
Zip: 327s0 Phone: 40744-s07a
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. Lucle 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 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 attorney before
comma work or recording your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for owner 5 aianature of Lontracto /License Holder
STATE OF FLORIDA
COUNTY OF eie.ard
The forgoing instrument was acknowledged before me
this 14 day of December 20 17 by
-
(Name of person acknowledging)
(Signature o otarV Public- State of Florida)
Personally Known V\ OR Produced Identification
Type of Identification Produced
Commission No.
ea
ao a ^ Publicotary State of FI
. C Sandra Leone
r•
Revised 07/15/2014 fixpire� oe1�a2o2o
REVIEWS FRONT ZONING
COUNTER REVIEW
INITIALS
STATE OF FLORIDA
COUNTY OF 0rovud
The forgoing instrument was acknowledged before me
this 14 day of December
AaMd.20�by
1�e (JA_e_
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �— OR Produced Identification
Type of Identification Produced
_,-,�
G' �----� a `Y 44?eal�otary Public State of
a�
Sandra Leone
�. of My Commission GG 0
SUPERVISOR I PLANS I VEGETATION I SEA TURTLE J MANGROVE
REVIEW REVIEW REVIEW REVIEW
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