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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: \\-- .e-/'---t ‘C i Permit Number: 1 1 1 050a
RC.64211,OTIOV,-:kiWqr
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: \---\., 0-,-c -._cA.._ Port St. Lucie, FL 34952
Legal Description: 3427-111-0002-000/5 Spanish Lakes Riverfront
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Demolition of Mobile Home
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AdditionalmaaitiOnal work to be errormea under tijhasislpermit-check-acnie4-ci5x.ail a'e#p0p4lryie4.1'0vw- 'in4'1o,4-6m4' ,;#4,c_4-t0wi?•:l,-,‘ei,"AN;te--,i1tSm..,_,
CI HVAC Gas Tank EIGas Piping Shutters ID Windows/Doors —
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0 Electric Li Plumbing 0 Sprinklers 11 Generator 1-1 Roof
Total Sq. Ft of Construction: S914 of First Floor:
Cost of Construction:$ 500.00 " Utilities:I 'Sewer[ii Septic Building Height:
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Name Wynne Building Corporation Name: Matthew Lyle Wynne 1
Address:8000 South US 1, Suite 402 Company:Wynne Development Corporation I
1 City: Port St. Lucie State:FL Address: 8000 South US 1, Suite 402
Zip Code: 34952iFax. 772-878-0224 City: Port St. Lucie State:FL
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Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-0224
E_man:sue@wynnebc.com I Phone No. 772-878-5513
Fill in fee simple Title Holder on next page(if different E-Mail: sue@wynnebc.com
from the Owner listed above) State or County License: CGC035999
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: I 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 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 lender or an attorney before
commencing work or recording your Notice of Commencement.
_Signature of Owner/Lessee/Agent Signature of'ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisk-gy of N0,3.0 20t by thisQ�- day of ,20 -.S( by
Matthew Lyle Wynne"- Matthew Lyle Wynne
Name of perso •cknowled in Name of ecsorr cknowled in
ignature of Notary Public-State of F a) „,-(Sig`nature of Notary Public- tate o ¢da)
Personally KnowrA,. ,X. Q.R Pr,R•.• ;e .e i.i. .n Personally Known X OR oduced Identification
Type of Identification_Produceif Type of Identification Produced
r•:'iUit^ISSIOW#FF 187647
Commission FebruatW019 Commission No "• SUSANMACEI(Seal) '
r u l lotar Pubic UnderwritersMI , t s MY COMMISSION#FF 187647
a _..�' EXPIRES:February 23,2019
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS