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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I NO -0377(
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
hone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEME.NTr:LOCATION(
r _. _.
Address: Port St. Lucie, FL 34952
Property Tax ID#: .part of 3414-501-1701-000/9-Spdni h Lakes One Lot No.
Site Plan Name: Block No.
Project Name:
DETAI,LED�D,ESCRiPTf:®,N ®F1NORK � try 1*t= - - --
Demolition of Mobile Home
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�CQ'NSTRUCTIO'NIINi RM%R=�10'N +� s
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:
'ODUNIER/LESSEE CONTRi4CTOR
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
Foil in fee simple Title (Holder on next page(if different E-Mail sue@wynnebe.com
from the Owner listed above) State or County License CGC035999
Of 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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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.
In1 consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work
ini 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
WICE 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
1 WITH'YOUR DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Sil =611W/Lessee/Contractor as Agent for Owner Signa a ofC actor/License Holder
SRIDA STATE F FLORIDA
COUNTY OF G COUNTY OF
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The forgoing instrument was acknowledged before me The forgoing.instrument was acknowledged before me
tliis day of 20,1�\ by this 'A day of c,�—r_e__- 20 a\by
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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 y 1
(Signature of Notary Ptibfic-State of Florida) ?(Signature of Notary Public-State of Florida)
Commission Nc � SUSANLA Commiss
MY COMMISSION#�GG 356204 t,�YP° SUSAN LAFLEUR
__ MY COMMISSION#GG 356204
a= EXPIRE :February,23,2023
REVIEWS wm-f
Bandai ru ticUnd t VISOR PLANS �5'Ab ru I IoSEAPEFURaliblilters MANGROVE
COUNTER REVIEW .REVIEW REVIEW REVIEW
i DATE
RECEIVED
DATE
COMPLETED
Rev. 2 7 19
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