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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: l IVW ' U 061 U
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Building Permit Application JUG �':'� 17
Planning and DevelopmentServices �ERiuil i t i/NG
Building and Code Regulation Division St: Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982 .
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential: X I'
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PERMIT APPLICATION FOR: Building
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PROPOSED IMPROVEMENT LOCATION:
Address:
15 VILLA.BLANCA
Legal Description. EAST 1/2 OF SECTION - TOWNSHIP 34S-- RANGE 39E
Property Tax ID #: '1301-111-0001-000-5
Site Plan Name: COUNTRY CLUB VILLAGE
Project Name: In.%o
�^ 29' 19' 15'
Setbacks From' Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
SINGLE FAMILY RESIDENCE (replacement home)- 2 BEDROOM 2-BATH - GPi
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CONSTRUCTION INFORMATION: j
Additional work.to be performed un er t is permit— c, ec a apply:
HVAC Gas Tank Gas Piping _Shutters Q Wi_rdows/Doors.
�✓ Electric 'Plumbing ❑Sprinklers Generator � Roof
Total Sq..Ft of Construction: 2,108 S .'Ft. of First Floor: 2,108 I
Cost of Construction: $ 58,000 Utilities:cnSewer LJSeptic Building Height:-
OWNER/LESSEE:
CONTRACTOR:
Name WYNNE BUILDING DEPARTMENT
Name: MATTHEW LYLE WYNN9
Address: 8000 SOUTH US HWY. 1 - SUITE 402
Company: WYNNE DEVELOPMENT CORPORATION
City: PORT ST. LUCIE State: FL
Address: 8000 SOUTH US HWY. 1 - SUITE 402
Zip Code: 34952 Fax: (772_) 878-7656
City: PORT.ST. LUCIE State: FL
Phone No.-(772) 878-5513
Zip Code: 34952 Fax: (772) 878-7656
E-Mail:
Phone No. (772) 878-5513
Fill in fee simple Title Holder on next page (if different
Ea -Mail:
from the Owner listed above)
State or County License: g8898
If value of construction is $2500 or more, a RECORDED Notice of Commencement_ is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: .: _ Not Applicable.
MORTGAGE COMPANY:.
_ Not Applicable
Name:. BRAZEN & BRAZEN
Name:
Address: 4ncocONUTAVE.
Address:
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City: STUART State: FL.
City:
State -
Zip: 34996 Phone; (772)287-8258
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Not Applicable
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Name:
Name:
Address:
Address:
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City:
City:
Zip: Phone:
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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 wok
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-residen _ial 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.vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF-E—e- COUNTY OF s�_
The forg i g instrument as acknowledged before me The forgoing instrument was acknowledged before.me
this may of 20 !! 7 by this day of 20 t 7 by
14 rw CS/GC YNrvt 104 77
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Not Public- State of Florida)
(Signature of Nota ublic- State of Florida )
_---,OR
e/
Personally Known OR Produced Identification
Personal) Known Produced Identification
y
Type of Identification Produced
Type of Identification Produced I
,,;;,a; DOROTHYANN BASKIN�.
Commission No. �: �'• COMMISRGG 030145
Commission No. "i ,..vP"A�
, r., t, DOR0TMPPA BASKIN
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EXPIRES: October 2, 2020
: f
l: : MY CQMMISION tt GG 030145
Public underwriters
a: v
;; Bonded ThN
", ' ' Notary PubIIC llnderemters
-Revised-07/15/2014
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DATE
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COMPLETE
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INITIALS.
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