HomeMy WebLinkAboutBUILDING PERMIT APPLICATION3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12.
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Building Permit Application
Planning and Development Services p�eQ��
Building and Code Regulation Division
2300Virginia Avenue, Fort Pierce FL 34982 PERP�IT- i,,v-
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial St. L ie Coy niy, FL
Residential
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: _6 P —7i ccit
Legal Description: CREEKSIDE PLAT NO. 1 (PB 55-12) LOT
Property Tax ID #: 2326-600- 10 _ 000 . Z
Site Plan Name: Lot No,-5—
Project Name:
Setbacks Front: Back: Right Side: ��
DETAILED DESCRIPTION OF WORK:
Left Side:
Construction for new Single Family Residence CCC.Q tBZ6 Le,�-(
CONSTRUCTION INRORMATION:'
Addition.. worN to ua orme un er t Is permit — c ec a app y;
�✓ HVAC Gas Tank ❑Gas Piping Sh tt
a�
fl:::
Electric C]✓ Plumbing Sprinklers
Total Sq. Ft of Construction: — {
Cost of Construction: $ �� ���� Ut
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. 321-733-2111
E-Mail: Melboumepermitting@DRHorion.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Block No.
_ . u cis Windows/Doors
Generator 91 Roof Roof pitch
S Ft. of First Floor: -
Ilities:2✓ Sewer Septic Building Height: il
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: Melboumepermitting0DRHorton.00m
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:
DESIGNER/ENGINEER: Not Applicable
Name: as oesign Group Inc.
MORTGAGE COMPANY; Not Applicable
Address: 1441 N. Ronald Reagan Blvd,
Name:
City: Longwood State: FL
Zip: azrso Phone Oar44sora
Address:
City.
State:
Zip: -_ Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Address:
Not Applicable
Name:
City:
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 anU 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 permitI 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 at
commencing work or recording your Notice of Co torney hafnrc+
Signatur�&Owne�rlLessee/Contactor Aent Olr wn
STATE OF FLORIDA
COUNTY OF wemd
The forgoing instrument was acknowledged before me
this-2E_dayof December 20 L7 by
(Name of person acknowledging)
(Signature o otary%puhlic- State of Florida )
Personally Known V \ OR Produced Identification
Type of Identification Produced
Commission No. �','0yY`
ear ,Qj Notary Public State of
: o, : Sandra Leone
Revised 07/15/2014 �'°���Oy II EX.. celse/zozo
nass rtwrrff=sr
�ofontra`ctor/License Signature- Holder
STATE OF FLORIDA
COUNTY OF a-v-d
The forgoing instrument was acknowledged before me
this 26 �dayy\1loof December 2
0 � by
Vu
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known �- OR Produced Identification
Type of Identification Produced
REVIEWS FRONT ZONING LlUPERVISOR PLANS
_ COUNTER REVIEW EV�W REVIEW
ATF
INITIALS
;-
ion No.
°tiv Qal)votery Public State of
_ (y Sandra Leone
= oQ M7 Commission GG 0
VEGETATION SEA TURTLE MANGROVE
I
REVIEW REVIEW REVIEW