HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-_
-- - — Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PRbPOSED.INCPROVE.MENT L®GATION?:
Address: Port St. Lucie, FL 34952
Property Tax ID#: Part of 3414-501-1701-000/9- anish Lakes One Lot No.
Site Plan Name: Block No.
Project Name:
DETAI,LED�;DESCRIPTIONrOFW�ORK s -r �y _ - - _ - -
Demolition of Mobile Home
CONSTRU}CTIQ'N�whNFtO;RMyATIQNr;~
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:
OUVNER/LESSEE,: CONTRAC!,OR
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 772-878-55.13
Full 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
If 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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=S �'I?PLE`�MiE�TA�L��CO S°�Tf2UC�TII®rN L„iEN LAW I�I� -®Ft+M � �"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:
Zilp: 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
struicture.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
"WikRNING 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
j POSTED ON THE 10.113 SITE BEFORE THE,FIRST INSPECTION. IF YOU INTEND.TO OBTAIN FINANCING, CONSULT
WITH YQUR-kENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF. MMENCEMENT."
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S" ure ner/Lessee/Contractor as Agent for Owner Sig re ntractor/License Holder
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STA OF FLORIDA ST E OF FLORIDA
COUNTY OF COUNTY OF
The forgoing m trument was acknowledged before me The forgoing inst ument was acknowledged before me
tliis,\ day o 20 A,by this day of a 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
Produced - Produced
(Signature of Notary Public-State of Florida) (Signature&f %e1 s
SUSAN I"LEUR
Commissio Irk` YF�B:" SUSAN LAFLEU eal I al
QTfi •• (� ) Commissi ndc , ':' y r'OMMISSIGN#GG35
MY COMMISSION it GG 356204 ;,i lx
Y, ,rorP, EXPIRES:FebNely 23,2023
EXPIRES;Februa 23,2023 ::r�,: a Public Underwriters
Bonded Thru hotary Public Underwri rs —--
REVIEWS � PERVISOR PLANS VEGETATION -- SEA TURTLE MANGROVE
COUNTER REVIEW .REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE'
.COMPLETED
Rev.2 7 19
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