HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE WO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' ��' �� Permit Number: 210 ' Oy3.^L,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34952
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: �_ �� ��c-`�� 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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Additi-on-al-W&-rkto e- art(rme un er t is permit—c ec a apply;
®HVAC Gas Tank ❑Gas Piping _Shutters E]Windows'Doors El
®Electric D Plumbing Sprinklers O Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 500.00 Utilities: Sewer Septic Building Height:
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Name WYnne Building Corporation Name: Matthew LyleWynne -
Address:8000 South US 1,Suite 402 Company: WYnne Development Corporation
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:FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-0224
E-Mail:sue@wynnebc.com Phone No. 772-878-5513
F111 in fee simple Title Bolder on next page(if different E-Mail: sue@wynnebe.com
from the Owner listed above) State or County License: CGC035999
If value of construction is.$2500 or more,a RECORDED notice of Commencement is required.
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DESIGNE R/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable u
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.
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.
F
_Signatur a�Owner/Lessee/Agent . Sign Co ctor/License Holder S
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucle COUNTY OF St.Lucle
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this`3 day of c 20 Eby this �a day of �`\�t 20Z�=�by
Matthew Lyle Wynn Matthew Lyle Wynne
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Not Public-State of Florida} (Signature of Notary Pubic-State of Florida)
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. SUSAWWL)`UR Commissi n No.
y Seal
r c*= MY COMMISSION#GG 356204 `r- `
*' ce 23,20 c�."•n�Pb�; SUSAN LAFLEUR
bF-0� Bonded Thru Notary Public Underwriters
's" EXPIRES:
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Revised 07/15/ •:qr., R �.February 23 2023
EOF"°P Bonded Thru Notary Public Undenttriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIE
W REVIEW REVIEW REVIEW
COMPLETE
INITIALS