HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJJJ -
ALL APPLICABLE INFO rMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
• .:tea I.-,i.r
Building Permit Application
Planning and Developmen, services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: �111 a,SC 1 -- 1— . _. , -
DEC 2 ? 2017
P =MIAII-AMNIG
St. Lucie County F-L
Commercial Residential x
Legal Description: CREEKSIDE PLAT NO. 1 (PB 55-12) LOT
Property Tax ID ##: 2326-600- (00t — 000 -,
Site Plan Name:
Project Name:
Setbacks Front C 'Back: �? Right Side: J'
Left Side:
DETAILED DESCRIPTION OF WORK:
Construction for new Single Family Residence
d Z
CONSTRUCTION INFORMATION:
AddI Iona war to 1-Tormea un er t Is permit —
4HVAC Gas Tank ❑Gas Pining
Y. Electric Q Plumbing 215prinl
Total Sq. Ft of Construction:
Cost of Construction: , 1
OWNER/LESSEE:
)o 1 a_s
Lot No._IS _
Block No.
_ShQutters Windows/Doors
ers Generator �✓ Roof
Roof pitch
SC4 Ft. of First Floor:
Utilitles:Sewer aSeptic Building Height:
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@DRHortan.com
Fill in fee simple Title Holder on 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
—`"" B41"avnaccrt: ___-Not Applicable
Name: AB Design Group Inc.
Address. 1441 N. Ronald Reagan Blvd.
City: Longwood State: FL
Zip: 32750 Phone: 407-0 -iswa
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: --'
Address:
City:
MORTGAGE COMPANY: "Not Applicable
Name:
Address:
City: State:
ZIP: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address.'
—"'
ZIP' Phone: 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 attorney before
comma work or recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner I St8natu� aCt „ S
wuccme noioer
STATE OF FLORIDA
COUNTY OF Breaard
The forgoing instrument was acknowledged before me
this 9_ day of December ZU 17 by
��% wl�oL Lecw
(Name of person acknowledging)
I
(Signature o otaryY�P((ublic- State of Florida )
Personally Known 0( OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
INITIALS
STATE OF FLORIDA
COUNTY OFer-,na
The forgoing instrument was acknowledged before me
this 26 day
of December �0 j7 by
------------
VaGfdrrw ���x e�
(Name of person acknowledging)
(Signature of Notary Public- state of Florida )
Personally Known �— OR Produced Identification
Type of Identification Produced
Ivtotary Public State of FI rid�m lion No.
Sandra Leone �"—�
o�� �aI] otary Public State of
Sandra Leone
Commission
Expires 00J1C/2020
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SUPERVISOR PLANS VEGETATION
REVIEW REVIEW
SEA TURTLE MANGROVE
REVIEW
REVIEW REVIEW