HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � I a+y `a n Permit Number:
Building Permit Application
Planning and Development Services JAN 2,4 2D2D
Building and Code Regulation Division ST. Lucie County, perm
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building — zz, V
PROPOSED IMPROVEMENT LOCATION:
Address: 186 CALLE DE LAGOS
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 Front34' Back: 29'
Right Side: 25' Left Side: 15'
Lot No.
Block No.
SINGLE FAMILY RESIDENCE (replacement home) - 2 BEDROOM - 2 BATH - GARAGE
NO SLAB WILL BE BUILT OFF REAR OF HOME
AaamonaiworKLOoe errormea unaer finis permit—cnecK au appry:
✓10HVAC Gas Tank DGasPiping_Shutters QWindows/Doors
ZElectric ✓❑_Plumbing []Sprinklers Generator Roof
Total Sq. Ft of Construction: 2,10E 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:
Name: aRA.DEN6aRADEN
Address: 417 COCONUT AVE.
City: STUART State: FL
Zip:34sss Phone:072I2sM2ss
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY: _Not Applicable
Name: _
Address:
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or ancovenantsthat 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.
_ Signature of Owner/ Lessee/Agent
s
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I COUNTY OF ST-"C P
The forgoing instrument was acknledged before me
this r3otdayof 7FcrM6Low20 Eby
/n'h-"4FW L vc-% 1AJklI Ive
(Name of persona owledging )
(Signature of Notary u lic- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION#GG 030145
So�ded Thru Noury Puhlic Undenvdters
Revised 07/1 L�t`#�""---
The forgoing instrument was acknowledged before me
this day of DEeew 56-r- . 20 ) 9 by
--e'yl'97nlr-w Zytf
(Name of person acknowledging)
6&" eaL.Q
(Signature of Not6ft Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission
MY COMMISSION # GG 030145
9onded Thtu Notary Public Underw ilers
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