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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �` �1 Permit Number: �1d3J Od��
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RECEIVED
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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: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 10 ALTA LOMA
Legal Description: SECTION 26/TOWNSHIP 36s/RANGE 40e
Property Tax ID#: 3414-501-1701-000/9 Lot No.10
Site Plan Name: SPANISH LAKES ONE / Block No.
Project Name: r/ U
Setbacks Front 23' Back: 26' Right Side: 24'2" Left Side: 12'2"
DETAILED DESCRIPTION OF WORK:
REPLACEMENT MOBILE HOME: SET UP AND TIE DOWN TO CODE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that appy:
Z✓ HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
ZElectric ✓❑—Plumbing ❑S 'nklers ElGenerator F] Roof
Total Sq. Ft of Construction: 1,539 S . Ft.of First Floor: 1,539
Cost of Construction:$ 12,312.00 Utilities:cn Sewer F]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name WYNNE BUILDING CORP. Name: WILLIAM D.BRANTLEY
Address:8000 SOUTH US HWY. 1 SUITE 402 Company: WYYNE DEVELOPMENT CORP.
City: PORT ST. LUCIE State:FL Address: 8000 SOUTH US HWY. 1 SUITE 402
Zip Code: 34952 Fax:(772)878-7656 City: PORT ST. LUCIE State:FL
Phone No.(772)878-5513 Zip Code: 34952 Fax: (772)878-7656
E-Mail: Phone No. (772)878-5513
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: DIH1016128-29524
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: STEVE WOODS Name:
Address: Address:
City: State: City: State:
Zip: Phone: (772)618-5644 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: 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 thepermit 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 our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Ho er
STATE'OF FLORIDA c' -I STATE OF FLORID
COUNTY OF O, LING(..- COUNTY OF `t- LVG(;�
The forgoing instr�nent was acknowledged before me The forgoing instru t was acknowledged before me
this day of / 20 Jaby this 5 day of eb&(AsM ,20 by
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(Name of person acknowle ng) (Name of person acknowledging)
(Signature of Notary` /
Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known T OR Produced Identification Personally Known 7` OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Ammission No. / `a3 (Seal)
iar vugo NO�ry udkaS�te of Frofida
43 ot9s`Y a Notary Public State of Florida
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P 0512512020 c My Commission FF 978543
Revised 07/15/2014 Of Exp�msi�oFfloP Expires 05/25/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE /f
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