HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:,
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Building Permit Application DEC ' 7 2917
Planning and Development Services
Building and Code Regulation Division PERMIT TING
1300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
PROPOSED IM''P^ROVEMENT LOCATION: K-
Address:
Legal Description: CREEKSIDE PLAT NO. 1 (PB 55-12) LOT
Property Tax ID #: 2326-600-
Site Plan Name:
Project Name:
Setbacks Front•_ �Backll
DETAILED DESCRIPTION OF WORK:
Right Side:
Construction for new Single Family Residence OV4 &V\
CONSTRUCTION INFORMATION:
L9IHVAC L=J Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ _-
OWNER/LESSEE:
Name D.R. Horton
Address: 1430 Culver Drive NE
Lot No.__ l 0
Block No.
Left Side: I c
2LO01 0 % k
Piping UShutters z Windows/Doors
nklers 0 Generator Z Roof
Roof pitch
So. Ft, of First Floor: 32-
Utilities: 0Sewer 0Septic Build ingHeight:
CONTRACTOR:
Name: Brian W. Davidson
Company: D.R. Horton
City: Palm Bay State: FL Address: 1430 Culver Drive NE
Zip Code: 32907 3-2Fax: 321-733-7092 city: Zip Palm Bay FL
Phone No. 321-73111 Code: 32907 Fax: State: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: Melboumeperrnitting@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:
-__ --- Not Applicable
Name: AS Design croup Inc.
Address: 1441 N. Ranaid Reagan Blvd.
City: Longwood State: FL
Zip: 32750 Phone: 407 4"07a
FEE SiMPLE TITLE HOLDER: ____ Not Applicable
Name-
Address -
city:
Zip: Phone:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not
Name: 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 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 attornev befnrP
commencing work or recording your Notice of Comme���
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Bia ad
The forgoing instrument was acknowledged before me
this ZrL day of December 20 L7 by
(Name of person acknowledging )
1
(Signature OT NotaryPuublic- State of Florida )
Personally Known 0( OR Produced Identification
Type of identification Produced
Commission No."1"N}iP
�tP°� °vs� -�Hotary Public State of
Sar,dra Leone
Revised 07/15/2014 1' °%iL°i Expires ct /�azozo
REVIEWS I FRONT ZONING
__ COUNTER I REVIEW
INITIALS
Si nature of ontractor/License Holder s
STATE OF FLORIDA
COUNTY OF a--d
The forgoing instrument was acknowledged before me
this 26 day of December
Q 20 17 by
V m c��� l e o p-2.
(Name of person acknowledging )
i
(Signature of Not Public- State of Florida )
Personally Known t-./— OR Produced Identification
Type of Identification Produced
SUPERVISOR I PLANS
REYIEW REVIEW
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NO. ral)`totary Public Slate F d
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Sandra Leone
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My Commisslon GG 02 1
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