HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAbLF INFO MY5T BE COMPLETED FOR APPLICATION TO Of ACCEPTED
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Bgildlriig
PROPOSEQ II1/IPftOVEMENT LOCATION:
Address: 35 5AN RODERTO
Legal Description: €AST 112 OF 69-OTION I T9YVN5HIP 045=RANO 691=
Property Tax ID#: Lot No.
Site Plan Name: QOUNTRY CLUB YILWO Block No.
Project Name:
Setbacks Front 57' Back: -34'6" Right Side: "14' Left Side: "15'6"
DETAILED DESCRIPTION OF WORK:
SINGLE-FAMILY RESIDENCE (replawwrlt home) - 1 BEDROOM- DEN - 1 1/2 BATHS- GARAGE
A IXI BLAB WILL BE BUILT OFF REAR OF HOME
CONSTRUCTION INFORMATION:
Additional work to e performed under this permit—check a apply:
®HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
®Electric ❑✓ Plumbing Sprinklers Generator ® Roof
Total Sq. Ft of Construction: 1,760 S Ft.of First Floor: 1,750
Cost of Construction:$ 50,000 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name VVYNNF-BUILDING DrEPARTM1=NT Name: MATTHF-W I_YI-1=WYNN
Address:6000 SOUTH US HWY, 1 -SUITE 402 Company: WYNNI=DEVELOPMENT CORPORATION
City: PORT ST, LUCIE State:FL Address: 6000 SOUTH US HWY, . 1 =SUITI=402
Zip Code: 64052 Fax:(772)676=7666 City: PORT ST, LUCII= State: FL.i'
Phone No.(772)676=5616 Zip Code: 34062 Fax: (772)676-7656
E-Mail: Phone No. (772)M-6616
Fill in fen simple Title Holder an next page(If different E-Mail:
from the Owner listed above) State or County License: 06696
If value of construction is$2500 or more,a REGARDED Notice of Commencement Is required,
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: BRADEN$BRADEN Name:
Address:417 COCONUT AVE. Address:
City: STUART State: FL City: State:
Zip: 34996 Phone: (772)287-82e8 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.
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.
s
_Signature of Owner/Lessee/Agent Signature of Contr ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF "� . LLLUt__-- COUNTY OF 2 . LULH__�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged kfore me
this day of 20ZDy this Q day of � (MI�20 y
(Name of person acknowledging (Name of person acknowledging)
Cd LL—Ro
(Signature o tary Public-State of Florida) (Signature of_9110 ary Public-State of Florida)
Personally Known I OR Produced Identification Personally Known
Type of Identification Type of Identification Procf JOY POLLARD
Commission fi GG 621 4
Comm�)s�si ;i My common Expires
Commission No. +`- My Co4� sion Expires Commission No. 1i
January 14, 2021
Janu ry 4, 2021
I
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS