HomeMy WebLinkAboutBuilding Permit Application t
ALL APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `Permit Number: co-C)l I -�5
Build,ing 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: To Select from dropbox, click arrow at the end of line
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Address: Port St. Lucie, FL 34952
Legal Description: 3427-111-0002-000/5 Spanish Lakes Riverfront
Property Tax ID#: Lot No.
Site Plan Name: Block No;
Project Name:
'Setbacks Front Back: Right Side: Left Side:
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i itiona -work to be e orme under t ispermit—checka apply: b_
QHVAC 0 Gas Tank ❑Gas Piping _Shutters []Windows/Doors
0 Electric M Plumbing OSprinklers El Generator Roof
Tcatal Sq. Ft of Construction: S . Ft.of First Floor:
Cast of Construction:$ 500.00 Utilities:cnSewer Septic Building Height:
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Name Wynne Building Corporation _ Name: Matthew Lyle Wynne
A,ddress:8000 South US 1, Suite 402 Company:Wynne Development Corporation
Ciity: Port St. Lucie State:FL Address: 8000 South US 1, Suite 402
Z'ip Code: 34952 Fax: 772-878-0224 City: Port St..Lucie State:FL
PlIone No, 772-878-5513 Zip Code: 34952 Fax: 772-878-0224
E,-Mail:sue@wynnebe.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 vtalue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
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.
Iln consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
iin 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
icommencing work or recording our Notice of Commencement.
s
=ATEF
wner/Lessee/Agent S ture Contractor/License Holder
RIDA STATE OF FLORIDA
COUNTY OF SLLu.ie COUNTY OF St.Lucie
'The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
ithis�,day of V*-,6_,r�\�- , 20 Z by this q day of�`�CS��.�U\1�-� .20 >�by
N9atthew Lyle Wynn4- Matthew Lyle Wynne
(Name of person acknowledging (Name of perso acknowledging)
r
(; ignature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Tyype of Identification Produced Type of Identification Produced
Commission No. ..... �US N UR Commission No. (Seal)
MY COMMISSION#GG 356204
SUSAN LAFLEUR
ualy
�'r oPo Public Undeixnitera �'I' :+ MY COMMISSION#GG 356204
o BondedThruNotary a:+
]Revised 07115 "' EXPIRES:February 23,2023
�FP.. Bonded ThN Notary Pubk Underxmters
(REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INJITIALS