HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number-
Building pp
- Buildin 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
PERMIT TYPE:
PRQPOSED IMPROVEMENT LOCATION:
Address: Port St. Lucie, FL 34952
Property Tax ID#: Part of 3414-501-1701-000/9-Spanish E es One Lot No.
Site Plan Name: Block No.
Project Name:
DETAILEDDESCRIPTIOWOF WORK
CONSTRUCTIO0,1 k
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ n""Y Utilities: —Sewer _Septic Building Height:
01N.NER/LES8-EE, CONTRACTOR
Name Wynne Building Corporation Name: Matthew Lyle Wynne
Address: 8000 South US 1, Suite 402 Company:Wynne Development Corporation
City: Port St. Lucie - State:_ Address: 8000 South US 1, Suite 402
Zip Code: 34952 Fax:772-878-0224 City: Port St. Lucie State:FL
Phone No.772-878-5513 Zip Code: 34952 Fax: 772-878-0224
E-Mail:sue@wynnebc.com Phone No772-878-5513
Fill in fee simple Title Holder on next page(if different E-Mailsue@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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SREAP. E--M2113NTAL C0NSTRUCT10N1iIEN,LAW INF;®RMATION
re #3�eM.s .1�".
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: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sig re o ner/Lessee/Contractor as Agent for Owner Si �TUE
re ontractor/License Holder
STATE OF FLORIDA ST OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this -N day of 20 2L-'� by this----N day of 20 4Z!by
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produ ,
*: *: MY COMMISSION#GG 356204 ; *: MY COMMISSION#GG 356204
EXPIRES,February 23,2023 o`, EXPIRES:February 23,2023
,oP f;°4'••Bonded Thru N&Und,mritera kqP v;Q"'• Bonded ThrU No Pubiic Undenvritera
(Signature o oar c- (Signa ure o o ary 15013117.State
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19