HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: AZ 1 % 11�_ Permit Number:n2!-'d(o,5(j
Building Permit Applicait6 201�
Planning and Development Services �( �C
Building and Code Regulation Division n,� OP
Virginia Avenue, Fort Pierce FL 34982 4 0
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 'I esitlentlNJ'--x.----.
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENTLOCATION:
Address: %` 0 011"1 A,A61
Legal Description: CREEKSIDE PLAT NO. 1 (PB 55-12) LOT
Property Tax ID #: 2326-600- I)(
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side.
Construction for new Single Family Residence lita(_C,_-
3� z
CONSTRUCTION INFORMATION:
HVAL L_J Gas Tank
Electric Q Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
•� I u
LeftSide: 4, I Via
r
Lot No.�
Block No.
a
rni — UnecK all apply:
In
Piping _Shutters Q Windows/Doors
j
nklers 0Generator �✓ Roof Roof pitch
S . Ft. of First Floor:
Utilities:0Sewer aSeptic Building Height:
OWNER/LESSEE:
Name D.R. Horton
Address:1430 Culver Drive NE
City: Palm Bay State: FL
Zip Code: 32907 Fax: 321-733-7092
Phone No. 321-733-2111
E-Mail: Melboumepermitting@DRHorton.com
Fill in fee simple Title Holder an next page ( If different
from the Owner listed above)
CONTRACTOR:
Name: Brian W. Davidson
Company: D.R. Horton
Address: 1430 Culver Drive NE
City: Palm Bay State: FL
Zip Code: 32907 Fax: 321-733-7092
Phone No. 321-733-2111
E-Mail: Melboumepermitting@DRHorton.com
State or County License: CRC1327068
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
J
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name: A80esign Groupinc.
Address: 1441 N. Ronald Reagan Blvd.
City: Longwood State: FL
Zip: 3275`` phone: 407.4"D78
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.
Is in Countmakes
anrepresentation
applicable' Hothat
e Owners Association rules bylaws or anCl covenants thec may estrlct 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
commencing work or recording your Notice of Commencement.
Signature of Owner/lessee/Contractor as Agent for Owner S 5�11d�/� S
= -•UF _ of ontractor/License Holder
STATE OF FLORIDA
COUNTY OF Bra.a,d
The forgoing instrument was acknowledged before me
this _6 day of December 111 17 by
vvc� Lecw
(Name of person acknowledging)
I
(Signature o otaryyPublic- State of Florida )
Personally Known (A OR Produced Identification
Type of Identification Produced
Commission No. fi"�`"Y _�'✓
4<aa• iy� -Rotary Public State of
Sandra Leone
Revised 07/15/2014
REVIEWS FRONT I ZONING
COUNTER REVIEW
INITIALS
Expires 0e/1012020
STATE OF FLORIDA
COUNTY OF smani
The forgoing instrument was acknowledged before me
this 26 day of December 20 1_ by
AamdP�L /eon
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �-- OR Produced Identification
Type of Identification Produced
w.n_nsa _
SUPERVISOR I PLANS
REVIEW REVIEW
No. • � T -r v v,r
;aaSraljVotery Public State of
Sandra Leone
�._ - oa My Commission GG 0
VEGETATION I SEA TURTLE MANGROVE
I
REVIEW REVIEW REVIEW