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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ti \, a0 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building— SCR
PROPOSED IMPROVEMENT LOCATION:
Address: 188 CALLE DE LAGOS
Legal Description: EAST 1/2 OF SECTION 1 - TOWNSHIP 34S - RANGE 39E
PropertyTax ID #: 1301-111-0001-000-5
Site Plan Name: COUNTRY CLUB VILLAGE
Lot No.
Block No.
Project Name:
Setbacks Front 36' Back: 28' Right Side: 1�`\ LeftSide: 12'6"
DETAILED DESCRIPTION OF WORK:a
SINGLE FAMILY RESIDENCE (replacement home) =.BEDROOM
NO SLAB WILL BE BUILT OFF REAR OF HOME
CONSTRUCTION INFORMATION: III
HaainonaiworKcooe errormea unaerinispermn— cnecKan apply:
Z✓HVAC Gas Tank ❑Gas Piping _Shutters ✓❑Windows/Doors
Z✓ Electric ✓❑_ Plumbing ❑Sprinklers Generator t+/Z Roof
Total Sq. Ft of Construction: 1,750 L� S Ft. of First Floor: 1,750
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: BRADENBBRADEN
MORTGAGE COMPANY:
Name:.
_ Not Applicable
Add resS: 417 COCONUT AVE.
Address:
City: STUART 'State: FL
Zip: 34996 Phone: (772)287-8258
City:
Zip: Phone:
State:
_
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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 Court 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
commencing work or recording your Notice of Commencement.
s
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA•
COUNTY OF COUNTY OFF— "c. r
The forgoing instrum nt was acknowledged before me The forgoing instru Ent was acknowledged before me
this�/�n� day of /� �20 Eby this 31 day of/,. ,20 �o by
/r/A-Y7we-&j LYcE lNY.NWe ✓ A-r7 &-T- L/Lg LUY,�,NE
(Name of person acknowledging ) (Name of;person.acknowledging)
(Signature of Nota ublic- State of Florida ) (Signature of Nota ublic- State of Florida )
Personally Known ✓ OR Produced Identification Personally Known 61*� OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. DOROT1i
AIBASKIN Commission No.11+ .��� "aY.•, uDHOInrArtSp )Cw
'+'.• ': MYCOMMISSION#GG 030145 _ ':,� MY OMMISSION#GG0301
i•p F EXPIRES: October 2,2020
•'1, :1t"' Bonded Thru Notary Public Undervmters
Revised 07/15/
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