HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 12-27-17ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' R. Permit Number.
COI , CqC
Planning and Development Services Building Permit Application DEC 212017
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: ( lam 1—I . . i,.
Legal Description: CREEKSIDE PLAT NO.1 (PB 55-12) LOT
PropertyTax ID #: 2326-600-
Site Plan Name:
Project Name:
Setbacks front %' Back:
DETAILED DESCRIPTION OF WORK:
Right Side: W_' I Left Side:
Construction for new Single Family Residence CCLU §
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CONSTRUCTION INFORMATION:
Lot No. I
Block No.
- - -- -- un" Nrnnrc -CneCK all napply;
0HVAC Gas Tank []Gas Piping _ Shutters
Q Windows/Doors
I Electric 10 Plumbing Sprinklers Generator Z Roof Roof pitch
Total.Sq. Ft of Construction:
S Ft. of First floor:
Cost of Construction: $ 2 ' Utilities:[✓ Sewerril- Septic Buiidin Hei g ght:
EE:
Name D.R. Horton
Address: 1430 Culver Drive NE
City: Palm Bay FL
State: _
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: Melboumeperrnitting@DRHorton.com
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:
Name: AB
Design Group Inc.
Address: 1441 N. Ronald Reagan Blvd.
City: Longwuad State: FL
Zip: 32750 Phone: 4a744•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 Association rules, bylaws or antl 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 attornev befora
commencing work or recording your Notice of --
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ma,ard
The forgoing instrument was acknowledged before me
this 9_ day of December 20 17 by
�_%AAI�L L"
(Name of person acknowledging)
i
(Signature o otaryyPublic- State of Florida )
Personally Known V \ OR Produced Identification
Type of Identification Produced
Commission No.h�S,h'P,rti,"
°i111a6taryPublic State of
? CG} Sandra Leone
Revised07/15/2014 ? •`a ,°o" ExpiresGtflQl.
A. .i-i A 1. L 1 , 1- .
Si nature of ontractor/License Holder 5
STATE OF FLORIDA
COUNTY OF an,y-d
The forgoing instrument was acknowledged before me
this 26 day of. December �0 17_ by
\101�e o A-e-
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known �— OR Produced Identification
Type of Identification Produced
REVIEWS I FRONT I ZONING L
ERVISOR I PLANS
COUNTER REVIEW VIfrW REVIEW
IATF
INITIALS
r r v 1'Y1r-1fd-
NO. =o0ar �al} ot3ry Public Slate or
. a Sandra Leone
o My Commission GG 0
VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW