HomeMy WebLinkAboutBuilding Permit Application ACL AppUCABLE INM MU11S,,T11 BE CAMPLE tEt?FOR APPLICATION To BE ACCEPTED 0
Date: 'O"�.17 Permit Number: V
m XRECu
OR
4- Building Permit Application
DEC 2 6 M7 -
Ptannbwg and MvekwentSecvices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34981
Phone:(772)4621553 Fax:(772)462--1578 Commercial Residential
PERMIT APPUCATION FOR: 7o Select from dropbox, dick arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:` ��.� �c���c�� c � Port St. those 34952
Legal Desa iption:partof 3494-5014709-00019-Spanish Lakes O
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Fronk Back: Right Side-.-_Left.Side:
[DETAILED DESCRIPTION OF WORK:
Demobion of mobile home
LCONMUCTION.INFOR i#ATIO I:
((''
Additional wor to tDe orme under this permit—check a appy:
EjHVAC U Gas Tank []Gas Piping _Shutters FIWindows/Doors
Electric Plumbing [3Sprinkfers Generator Roof
Total.Sq.-Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities Sewer[jSeptic Building.Height:
OWNER/LESSEE: CONTRACTOR:
Nameyvynm f3u�diry CotporaftOn Name:Mattheur Lyle Wynne
Address:8000 South US 1,Suite 402 Company Wynne Development Corporation
may. Port St Lucie Stater- Address. 8WO South U$1,Suite 402
4p Code:34$52 x.772-878-0224yF f'eNt SLLucie fie:FL
Phone No.772-879-5513 Tap Code: M52 FWC.772-878-=4
E-MaikwAaw►mmbc-°om Phone No. 772-878-5513
Flit in fee s mp%Tide i#olcter on next page(if dMii:=:r+ent E-Mail:sue@v1mwbr c om
from the Owner listed..above) State or County License: CGC035M
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIM
DESIGNED ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name- Name:
Address: Address:
City: State: City: State:
Zip: 'hone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ____Nat Applicable
Name: Name:
Address: Address:
city.. City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lucie Counttyy makes no representation that.is granting a Permit will authorize it holder to build the subject structure
which is in.conflict with any applicable Home owners Association rules,bylaws or =enants that may restrict or prohibit such
structure_Please consult with your Home owners Association and review your d for any restrictions twhich may apply.
in consideration of the granting ofthis requested permit,I do hereby agree i will,in all respects,perform the work
in accordance with-the approved plans,the Florida Building Codes and St. cie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review=room additions,
accessory structures,swimming Po/anbcord
Is,signs,screen rooms and accessory uses to another n i use
WARNING TO OWNER:Your fa Notice of may result in your rig twice for
improvements to your properof Com ncement must be recorded and post on the jobsite
before the first inspection.If ob financing,consult with fender or an a rney before
commenci work or rem ' of Commencement.
Signature.of Qwnert tessee/A$ent Signature of Contra r cerise Holder
STATE OF FLORIDA STATE OF DA
COUNTY OF sL Lucia COUNTY OF.sL uc*
The fa ng i. t was ada+:}wledged before me The forgoing instrument was acknowledged before me
this'ray of\ cthis �"i�daf10€ Zo by
Mak-LyleVvy— Mrwh wLyle wyrm
(Name of person acknowledging.) (Name of acknowledging
rgnature of Notary Public-State o€ da) ( a ur of Notary Pubiiu-5iate o€ Ida}
Personally Known x OR Produced Ideriffi ation Personally Known x OR Produced Ident"uficirtion
Type.of Identifii(a don duc Type of Identification Produced
PuQ4�; SU AN GEE SUSAN MASEE
�(3mnll5Sit3 a"µr nydL' �
Commission No. MY COM a FF 1876x7 ��try
p= EXPIRES Februa 23,2019 + i1AftS5tON li FF 187647
'%�• �`�', Bonded Tluu Nota Pu tY .,
EXPIRES:February 2a,2019
Revised,0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SFATURTi.E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE J_
COMPLETE
INITIALS j