HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE
jj INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: GYz' /chi �� Permit Number:
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 Res
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 69 GRANDE CAMINO WAY
Legal Description: EAST 1/2 OF SECTION 1 - TOWNSHIP 34S - RANGE 39E
Property Tax ID #: 1301-111-0001-000-5
Site Plan Name: COUNTRY CLUB VILLAGE
Project Name:
Setbacks Front 30' Back: 19' Right Side: 13' Left Side: 13'
DETAILED DESCRIPTION OF WORK:
0 3 a'�
FEB 12 2Vc
Permitting depc�rtrnent
St. L
I e County, PL
Lot No.
Block No. _
SINGLE FAMILY RESIDENCE (replacement home)- 2 BEDROOM - 2 BATH -GARAGE
NO SLAB WILL BE BUILT OFF REAR OF HOME
I CONSTRUCTION INFORMATION: I
Nuutuonai worK co oe errormeu unuer cnis permit— cnecK au apply:
Z✓ HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Z✓ Electric ❑✓_ Plumbing ❑Sprinklers Generator Z✓ Roof
Total Sq. Ft of Construction: 2,108 S Ft. of First Floor: 2,108
Cost of Construction: $ 58,000 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WYNNE BUILDING DEPARTMENT
Name: MATTHEW LYLE WYNNE
Address: 8000 SOUTH US HWY. 1 - SUITE 402
Company: WYNNE DEVELOPMENT CORPORATION
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: (772) 878-7656
Phone No. (772) 878-5513
Address: 8000 SOUTH US HWY. 1 - SUITE 402
City: PORT ST. LUCIE State. FL
Zip Code: 34952 Fax: (772) 878-7656
Phone No. (772) 878-5513
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: 08898
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: BRADENaBRADEN
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 417 COCONUT AVE.
Address:
City: STUART State: FL
Zip: 34996 Phone: (772)287-8256
City: State:
Zip: Phone:.
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
s
_ Signature of Owner/ Lessee/Agent Signature of Contractor/LicenseHolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF S(. iuecrr COUNTYOF 5 - "CrB
The forgoing In ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 ,?—Oby this _30 day,of 20 by
{�YQ7-FH )xw C/ HYLE YNAre i�i7A7%}/�ZJ �YCF %VYiyvc
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Nota blic- State of Florida ) (Signature of Nota ublic- State of Florida )
Personally Known ✓-`� OR Produced Identification Personally Known . ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission
MY COMMISSI ON # GG 030145
'f Bonded Thor NotaryPublic Undermters
Revised 07/ c �� 53'X
Commission
DOROTHYANN BASKIN
MY COMMISSION # GG 030145
EXPIRES: October 2, 2020
Bonded Thar Notary Public Underwriters
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