HomeMy WebLinkAboutSaddlebrook Dr 7812, Permit App (Waterline)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
_J,
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT TYPE: Water supply line
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential "Z/
Address: 7812 Saddlebrook Dr, Port St Lucie, FL 34986
Property Tax ID #: 3321-501-0004-000-1
Site Plan Name:
Project Name:
Lot No.4
Block No.
DETAILED DESCRIPTION OF WORK:
Run water line from the meter to the house on the left hand side of the home. (See attached drawing)
CONSTRUCTION INFORMATION: i
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers Generator T Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 400
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael Miller
Name:
Address: P.O. Box 13208
Company:
City: Fort Pierce State:
Zip Code: 34979 Fax:
Phone No.772-216-1872
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: Mike@tradewindsroofing.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
11 Value w W11hirucupn is �cDuu or more, a Ktl,VKULL) Notice of commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applica
Name:
Address:
City: State
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_-___
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN A RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of owner/ Lessee/Contractor as Agent for Owner
STATE OF FLOfUDA
COUNTY OF C_.
The �for'�Dg instru ent was acknowledged before me
this �v day of f4p f 20 Z_I�jby
Name of person making
�statement,
`
Personally Known `-" OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub
Commission No.
rikia Lyne Wiikin
NOTARY PUBLIC
i )E OF FLORIDA
Comm# GG103860
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of , 20 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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