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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: as)
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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
PERMIT TYPE:
PROPOSED IM *QVEMENT LOCATION ro
Address: 0-�-� Port St. Lucie, FL 34952
Property Tax ID#: part of 3414-501-1701-000/9-Spanish Lakes One Lot IVo.
Site Plan Name: Block No.
Project Name:
DETAILE715 R MM
D DESCRIPTION O#FWORK ${ Fy s`
Demolition of Mobile Home
214
CONSTRUCTION INFORMATION x &
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 500.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE " CONTRACTOR '..
, .
Name Wynne Building Corporation Name:Matthew Lyle Wynne
Address:8000 South US 1, Ste 402 Company:Wynne Development Corporation
City: Port St. Lucie State:_ Address:8000 South US 1, Ste. 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 No 772-878-5513
Fill in fee simple Title Holder on next page (if different E-Mail sue@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.
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SU;PPLE11/IENTAL CQNSTRUCTION LIEN LAW INFQRIVIATIQN 4
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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 YO DER OR AN ATTORNEY BEFORE RECORDING YOU E O_f COMMENCEMENT."
S' atur Owner/Lessee/Contractor as Agent for Owner natur of Contractor/License Holder
STATE OF FLORIDA S TE OF FLORIDA
COUNTY OF � —L�-c..G COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2_ _� day 202E_j by this -2_\day of 20"Z-Cby
Matthew Lyle Wynne Matthew Lyle Wynne
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 Produced
(Signature of Notary Public-State of Florida '(Signature of Notary Public-State of Florida
SAN
Commission or•;r+�" S� Iwill It�� Commission10 SUS�I�#�
a EXPIRES:February 23,2023 a. EXpIREmy S February 23,2023
My FG-10-1-M-iij
REVIEWS LL' ZONING SUPERVISOR PLANS ATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19