HomeMy WebLinkAboutBuilding Permit Application A
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / �a
Date: _�1�� Permit Number: o Gy e
- 5�V Building permit Application gfcelveo
Planning and Development Services 5@�
Building and Code Regulation Division 1
2300 Virginia Avenue,Fort Pierce FL 34982 artment
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentiff=r.St.I e county
P�ERMITTYPE:
P�ROPO,SED,IIVIPROUE�M�E'RITc�L®GATIO-N1: � —
Adtlress: t o Port St. Lucie, FL 34952
Pro perty Tax ID#: Part of 3414-501-1701-000/9- panish Lakes One Lot No.
Site Plan Name: Block No.
Project Name:
DE4TAILE® DE�SCRIPTI®aN ®FWOftK z
r_ _
Demolition of Mobile Home
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�.NSTR`UCTI®'N,iINFOR�M"ATION; k
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:
OVN�ER`/LESSEE # w CONTRACTOR -
g'.s r�+...3'iS.+t' _,`,"f}e• r`{,:
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
Full in fee simple Title Holder on next page S if different E-Mail sue@wynnebc.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.
If value of HvAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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�UPPLSM2MIM WE
EI\Fl3ENTA,L C®! ST'SIJICTI.®IsI�LIE L'�W/ INFORM ��'I®N:
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
stricture.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
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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
"W1,i. RNING .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,OlU THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH'YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI OF COMMENCEMENT:"
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Si re of ct er/Lessee/Contractor as Agent for Owner Si ure o ntraor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -� l s��• P — COUNTY OF
The forgoing instrument was acknowledged before me The forgoing.instrument was acknowledged before me
this\ day of Cc�-N-1 ,201� by this N�,_day of 202N by
atthew Lyle Wynne Matthew Lyle Wynne
Name of person making statement. Name of person making statement.
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
P loduced Produced
' Ignature of Notary` ublic-State of Florida) (Signature of Notary P Ic-Sta a of Florida)
Commiss rh:( >r%ey''•; SUSANLAFLEUR (Seal) Commi io P 4Y SUSANLAFLEUR Se
(¢ MY COMMISSION#GG 35620�4 MY COMMISSION GG 356204 I
:"' EXPIRES:Februa 23,2023
Bonded Thru No ry Public Underwriters Bonded Thru Wary Public Underwriters I
R E V I E `:�PF i UPERVISOR PLANS MANGROVE
COUNTER REVIEW .REVIEW REVIEW REVIEW REVIEW REVIEW
{DATE
I RECEIVED
DATE
O M PLETED
Rev.2 7 19
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