HomeMy WebLinkAboutBUILDING PERMIT APPLICATION r
All APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �-
Date: Permit Number:
U,; a—_ RECEIVED
A
DEC 16 1011
Building Perrnit Application Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSED)iM!PROVEM+ENT.L®CATION:
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Address: �� ��a� `(� 0��� Port St. Lucie, FL 34952
Property Tax ID#: Part of 3414-501-1701-000/9-Spanish Lakes One Lot No.
Site Plan Name: Block No.
Project Name:
DE7AI+LED ®,ESCRI'PTION ®FW®rRK�
Demolition of Mobile Home
COfVSTRl1CT[ON�IMFOrRMAT,[ N° z
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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:
0;1NIV+ER/LESSEE. <` CONTRAtCT®R ry
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
Fall in fee simple Title Holder on next page(if different E-Mail sue@wynnebc.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 IHVAC 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:_
Zilp: Phone: Zip: Phone:
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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.
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
,,wA NING 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 J B ;SITE BEFORE THE FIRST INSPIECTION. IF YOU INTEND TO. OBTAIN FINANCING, CONSULT
WGTII YOU R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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00,0wre caner/Lessee/Contractor as Agent for Owner Si re o ntractor/License Holder
04
41 SPATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 7�� , L.-ram COUNTY OF
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The forgoing instrument was acknowledged before me The forgQi'ng.instrument was acknowledged before me
tliis���' y off_ r�_,��_� ,2Q by this�`�'day of
203_1 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
Pioduced Produced /
Signature of Not -(Signature of Notary Public-State of Florida)
,`o4YF�s�c, SUSAN LAFLEUR
Commission No. MYCOMMIS4Ii )GG356204 Commis t�sf�l � k; SUSANLAFLEUR Seal
o�= EXPIRES:February 23,2023 I GG 353"
Bonded Thru Notary Public Underwriters =°;;• ;off= EXPIRES:February 23,2f."
>.?FF;,•'` BondedThru I lotary Public nd ,REVIEWS FRONT ZONING SUPERVISOR PLANSTMtTATr=`MTTMLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2 7 19
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