HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: IOU -
Building Permit Application
fanning and Development Services
uilding and Code Regulation Division
300 Virginia Avenue, Fort Pierce FL 34982
hone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
'ERMIT TYPE:
�����-���a� �� c:+��.� Port St. Lucie, FL 34952
Address:
Property Tax ID #: part of 3414-501-1701-000/9-Spanish
Site Plan Name:
Ploiect Name:
One
Lot No.
Block No.
DETAI,LEDDESCRIP :[ONu®F,WOF3K :I
of Mobile Home
}CONSTRU'CTI,®;Nti.I.NF,RMrATI
ditional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
tal Sq. Ft of Construction: Sq. Ft. of First Floor:
st of Construction: $ 500.00 Utilities: —Sewer —Septic
Windows/Doors
Roof Pitch
Building Height:
TAWNIER%ESSEEi=-
Name Wynne Building Corporation
Address: 8000 South US 1, Ste 402
City: Port St. Lucie State: _
Zip Code: 34952 Fax: 772-878-0224
Phone No. 7727878-5513
Name: Matthew Lyle Wynne
Company: Wynne Development Corporation
Address: 8000 South US 1, Ste. 402
City: Port St. Lucie State: FL
Zip Code: 34952 Fax: 772-878-0224
Phone No 772-878-5513
E-Mail: sue@wynnebc.com
Full in fee simple Title Holder on next page ( if different
from the Owner listed above)
I
E-Mail sue@wynnebc.com
State or County License CGC035999
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
value of HVAC is $71,500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE COMPANY:
3Am[N&W_
_ Not Applicable V
DESIGNER/ENGINEER: _ Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name: -
Address:
Address:
City:
City:
IZip: 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.
Thefollowing 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
"IWARNING 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
j 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."
i�
ISignat w Lessee/Contractor as Agent for Owner
c c-r/License Holder
Si=TEFLORIDA
!
LORIDATE A
S
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20'.Lby
this day of `�:y ., —,o 20 Q-,by
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
(Sig ature of Notarylublic- State of Florida)
(Si ature of Notary Public- State of Florida )
i
CommissiorSUSANLAFLE II11
YCOty IDS11 #G ;9904
Commission )
EXPIRES: February 23, 2023
�irr?Y SUSAN LAFLEUR
' 9i 204
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REVIEW
DATE
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DATE'
COMPLETED
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