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ALLAPPLIC ABLE INFO MUST BE COP TED FOR APPLICATION TO BE ACCEPTEi'-
Date: Permit Number 211)4—
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- Ss RECEIVED
Building Permit Application €
Planning and Development Services JUN 2 1 ZO<1
Building and Code Regulation Division
ment
. 300 Virginia Avenue,Fort Pierce Ft 34982 PerSt, Lucting De.0 tv
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential se. Lucie cot,�r�
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
1PRflPOSE��l'+l1:PROVEMENTF.LCOCATII� < . :, :. k '.. .. . ..,
Address:
Fort Pierce 34951 }
��.\l`��- rt.-� L�G � .r-� �
Legal Description: part of 1301-111-0001-00015-Spanish Lakes Country Club Village
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Property Tax ID#: Lot No. l i
Site Plan Name: Block No. T'
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Project Name:
Setbacks Front Back: Right Side: Left Side
[3ETAt�.ED DESCRIPTI€7�I�,E�F�t1fC�R,I�.,�, „ ,z " 31 S
Demolition of mobile home I
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i.tiona wor to e e orme un er t is permit—c ec a t apply: t:
UHVAC ILA Gas Tank Gas Piping _'Shutters E]Windows[Doors
Electric Q Plumbing [ISprinkiers 1,!Generator Roof
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Total Sq. Ft of Construction: S . Ft,of First Floor: a'
Cost of Construction:$ �Z'� Utilities: _Sewer E]Septic Building Height: '
NameWYnne Building Corporation i Name: Matthew Lyle Wynne :
8000 South US 1,Suite 402 Wynne Development Corporation
Address: Company: Y p �
City: Port St. Lucie State:FL Address: 8000 South US 1, Suite 402 :
Zip Code: 34952' Fax:772-878-0224 City: Port St.Lucie State:F
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 Holdee on next page(if different E-Mail: sue@wynnebc.com
from the Owner listed above) State or County License:
CGCO35999
if value of construction is$2500 or more,a RECORDED iUotice of Commencement is required. ?
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S PP IUI NT41 CONS- T U` 1 ►j Ll l�f I U )I P RIM,- , l+OIV:
DESIGNER/ENEi1NEER.: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: j
Address: Address:
City: State: City: State
Zip: Phone: Zip: Phone: .
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY. _Not Applicable
Name: Name: r
Address: Address:
City:' City: s.
Zip Phone: Zip: Phone:
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1 certify that no work or installation has commenced pnorto 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 struaure
which is in conflict with any applicable Horfte Owners Association rules,bylaws or and,covenants that may restrict or prohibit such
structure.Please consult with your dome Owners Association and review your deed for any restrictions which may apply. s
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work A
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, r.
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use f
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 w rk or recording our Notice of Commencement.
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atur Owner/Lessee/Agent Sig a of ractor/6icense Holder
Si'A OF FLORIDA STATE OF FLORIDA t:
COUNTY OF SLUICiP COUNTY OF stucie.
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The rgaing instrument was acknowledged before me The forgoing instrument was acknowledged before me :1
this�da of 20��b th[s C da of 20 b 1.
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Maftev,Lyre wyong- MaMew Lyre Wynne (:
(Name of per a acknowledging (Name;affeppern acknowledgin r
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Si nature of Notary.Public-State of Floriida
(� ignatttre of Notary Public=State of Florida) �g rY
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type'of lde Type of Identification Produced l'
�P yg , SUSANLAFLEUR
comma_Issior ta.�°^' My cOMMISSI0N#GWA04 Commission I c:
EXPIRES:February23,2023 lrnc?yg SUSAN LAFLEURBonded Ibni r
•.;c, �o '` MY COMMISSION#GG-W 04
EXPIRES:February 23,2023 l:
Revised 07/15/2014 $,i; Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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INITIALS