HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • e` 7. 17 Permit Number: � � a • � r
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Planning and Development Services Building Permit Application
LLI
® 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: L. L T�
Legal Description:
Property Tax ID #: 232(.o —p0 O q _ 0110 ^ 2
Lot No.
Site Plan Name:
Project Name: _
Block No.
Setbacks Front ' Back: 0,10 Right Side: 20`52hLeft Side: 00.
DETAILED DESCRIPTION OF WORK:
Construction for new Single Family Residence /\�2 ei e i R(,�}-
CONSTRUCTION INFORMATION:
i iona wor to a orme un er t is ^9rmit�ceca a
[4HVAC ` PP Y
Gas Tank_Shutters Windows Doors
Electric OPlumbing [ZSprinklers Generator Z Roof Roof pitch
Total Sq. Ft of Construction: S . Ft, of First Floor:
Cost of Construction: $ 33 a Utilities:�5ewer Fla t' B
p uilding Height:
OWNER/LESSEE:
Name D.R. Horton
Address: 1430 Culver Drive NE
City: Palm Bay FL
State; _
Zip Code: 32907 Fax: 321-733-7092
Phone No, 321-733-2 111
E-Mail: Melboumepermitting@DRHorton.com <i:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
CONTRACTOR:
Name: Brian W. Davidson
Company: 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
State or County License: CRC1327068
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
17
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SUPP�LEfENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name: AS Detlign Group Inc1111- —auiC.
Address; 1441 N. Ronald Reagan Blvd.
City: Longwood State:
Zip: 32750 Phone: 40744-6eta
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
Address.
City:
Zip: Phone:
MORTGAGE COMPANY: N
Name: ot Applicable
Address:
City: State:
ZIP: - -. Phone:
BONDING COMPANY:
Name:
Address:
City:
ZIP: — Phone:
Not Applicable
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 an tl 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
commencine work or recording your Notice` of Co -
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 9,e,a,i
mmencompr,t•
The forgoing instrument was acknowledged before me
this _ day of 20 _by
�—% WfVo— 'L,,
(Name of person acknowledging)
T111
(Signature )f 11 C 13 llyublic- State of Florida )
Personally Known 0( OR Produced Identification
Type of Identification Produced
Commission No.
ea�' °tpnr a„s otary Public State of FI
Sandra Leone
Revised 07/15/2014 5 I`� - I aEx.. ce/yc. .
Si nature of ontractor/License Holder s
STATE OF FLORIDA
COUNTY OF a--,,
I 20 — by
(Name of person acknowledging )
f
(Signature of Notary public- State of Florida )
Personally Known �>Z—' OR Produced Identification
Type of Identification Produced
ft—A ."
The forgoing instrument was acknowledged before me
this _ day of
REVIEWS FRONT ZONING SUPERVISOR PLANS
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INITIALS
T Y Y ll' YYY'
No.fual%lotery Public State of
'0P Sandra Leone
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VEGETATION I SEA TURTLE I MANGROVE
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