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7 ABLE INF-0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- Permit Number. �
9 -
Building Permit Application
Planning and DevelopmentSeadbess
Building and Code Reguiddon Division
23M Virginia Avenue,Fort Pierce FL 34982
Phone:(7721462-1553 Fax:fmy 462--1578 Commercial Residential
PERMIT APPUCATION FOR: To Select from dropbox, click.arrow at the endof line
PROPOSED-:lfl.VROVE HIEN LOCATION
Address: .-c c��co C��.r,-L' _ Port St. Lucie 34952
Legal Description:Part of 3414-501-1701-0=9-.Spanish Lakes One
Property Tax ID#; No.
Site Plan Dame: Block No.
Project!Flame: �
Setbacks Front Back: RightSide: LeftSide:
DETA3.ED.OEst.P1P:1�o O:F-WC)RK
Demolition of mobile home
Additional uro=t to (e ertorme un er t �s permit— ec c a t app y
LJ
HVAC L-.—�Gas Tank []Gas Piping _Shutters F 1 lmdows/Doors
L�Electric Lam.!PlumbingSprinklers Generator Roof
Total:Sri..Ft of Constructlan: .Ft.of First Floor:
Cost of Construction:$ `s� Utilities Sewer Septic Building Height:
PWNE:R/1_ESSEE: . 0 311~'�AC"t 3 " ...
I NamevVYnne Buildi
p9 Cotpota6ior► Maine: MaMew Lyle Wynne
Address: 880 SSouth US 1,Suite 402 Company:ane Dev�elopmerit C;orporarm
City; Port St Lucie Statefl- Address: 8000 South US 1,Suite 402
( Zip Code:$4952 g=772-878-=4 may.Port St,Lucie 5tate:f=L
Phone No,772-878 513 Zip Code: X82 Fax:.772-8784=4
E Maihs nnebc room Phone No, 772-878-5513
Fill in fee simple Title Hotder on next page(if dKIW ent E-Mail- sue@wynneb,—,COM
fsard the Ow=w listed,above) State or Cour �C�CU35`s99
ty License:
df value of construction is$25oti or more,a RECORDED!Notice of Commenceawnt is rega".
SUPPLEMENTLAL CONSTRUCTION LIEN LAW INFORMATION:
DESI 3RIER/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: ___-Not Applicable
Name: Name:
Address: Address:
city: city:
Zip Phone: Zip: Phone: i
I certify that no work or installation has commenced prior to the issuance of a permit..
St Lucie Counttyy makes no representation that is granting a permit will authorize the it holder to build the subject structure
whkh is in.corrll`ict with-any applicable Home Owners Association rules,bylaws orand 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,l 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
accessory structures,smmming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Ripe d a Notice of Conmtercementimay resuk.in your paying twice for
improvements to your property.A Notice=of Commencement must be recorded and po on the jobsite
before the first inspe on.if you intend to obtain financing,consult with lender or a orney before
commencingwork cord, our Notice of Commencement.
1 �
S
I Signature of owner/ Signature of Contractor/Lice
I
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF.sL 6,de
The f�aing instrument was adceowledged before me The forgoing instrument was acknowledged before me
chi day of Zfl this 6 air of crr,�, 20�iaY
Mawm%v Lyte Wpm.. MalHww Lyle VVPM '
A (Name of acknowledging,) (Name of pemon acknowledging)
igri� a of Notary Public-State rida) (signature of Notary Public-state o nda)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type.of Identification Produced Type of identification Produced
i
Commission No. Hx U EE Commission N
MY COMMISSION#FF 181&47 �.
__<,,,; •� ,,rqi Y A•,4,.w , SUSAN MAGEE
%p;;F�°�- BondedThn iwta Pu6lcUndavr t `^- 'rXPInGS
Februa23,2.19ern
Revised 07/151ersT
16
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