HomeMy WebLinkAboutBuilding Permit ApplicationALL A INFO MUST BE COMPLETED FOR APPUCATION TO 13E ACCEPTED
Date:
Permit Number
Building Permit APplication
Planning and Development SeadceS
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential i
Phone: W2) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, crick arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Port St. Lude 34952
Legal Description: Part Of 3414-501-1701-00019 - Spanish Lakes One
Property Tax ID #: Lot NO.
Site Plan 'Name:
Project Name:
Setbacks FrontBack- Right Sider_ Left Side:
DETAILED DESCRIPT ION OF WORK:
Demolition of mobile home
Block No.
CONSTRUCTION INFORMATION: III
E1HVAC Li Gas Tank
Illectric F1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Piping Hshutters F] Windows/Doors
nklers 0 Generator Ofloof
Sq. Ft of First Floor:
Utilities: U Sewer liSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameVVM Buffdft Corporation
Name. Matthew Lyle Wynne
Address: 8000 South US 1, Suite 402
Company: Wynne Development Corporation
Citv: Port St. Lucie State -FL
Address: 8000 South US 1, Suite 402
Zip Code: 34952 Fax.772-878-=4
Cty- Port St tAide State: i"L
Phone No.772-878-5513
Zip Code. 34952 Fax 772-8784)224
E-Mail:3ueQwinnebc-c0m
phari,. No. 772-878-5513
Fill In fee simple ride Holder on next page ( N different
E-Mail:.sue@vWnnebr—com
from the Owner listed above)
State or County License: CGC*35999
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: - State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: yNot Applicable
Name:
Name:
Address:
Address:
City.
City:
Zip: Phone:
Zip- Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lude CDunlW makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con) Ict 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 Ronda Building Codes and St Lude County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review.- room additi
accessory structures, swimming pools, fences, walls, sivw% screen rooms and accessory uses to another non-.- - ential use
WARNING TO OWNER: Your �failufe Record a Notice of Conmmw*ment may rawk your "ng twice for
I cl o
p
3'e and
improvements to your property. otice of Commencement must be recorded po on the jobsite
before the first inspecoon. If, ZyIntend io obtain financing, consult with lender or -an orney before
I 77eze
commencing work or'Acord* vour Notice of Commencement
Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF st-Lude
The f o . instrument was acbmMedged before me
this ;n ofa3�-�20 n_by
Matthew Lyra wflulk
Notary
Personally Known x OR Produced Identification
Type of Identification ewAV&@A..._
Commission No.
Revised -07/15/2014
SUSAN GEE
MY Co =# FF 187647
EXPIRES: February 23, 2019
STATE OF FLORIDA
COUNTY OF sL uft
The forgoing instrument was acknowledged before me
this J!t%tQ%aV of k,�
= 0 20 N:"'% by
Mew— Lyle W)—
(Name of pers
Notary Public- State of
Personally Known x OR Produced identification
Type of Identification Produced
Commission No.
MY COMMISSION 9 FF 187647
Bonded Thm Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
t