HomeMy WebLinkAboutBUILDING PERMIT APPLICATION•
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION -TO BE ACCEPTED
Date: SCAM Per Number:
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- Building: Permit Application,.,Juiv
Planning and Development Services
�St Et,19'Department
Building and Code Regulation DiVision �
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2300 Virginia Avenue,'Fort Pierce FL 34982.
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Phone:. (772) 4614553. Fax:. (772) 462-1-578 Commercial. ."Residential: x' -
PERMIT -APPLICATION FOR:- Other ''
PROPOSED IMPROVEMENT LOCATION:
.Address:
12.MAYA;WAY
Legal Description:. SECTION.26 /.TOWNSHIP.36s / RANGE 40e
Lot No. -
3414-501-'1701-000/9PropertyTaxID#;
Site Plan Name: SPANISH LAKES'ONE
.Block No.'
.
Project Name:
Setbacks _ :Front128': Back: 33'. "RightSide: 12'8" Left Side:: 12'8"
DETAILED.DESCRIPTION OF WORK: '
REPLACEMENT:MOBILE'HOME:'SET UP AND TIE: DOWN: TO CODE
CONSTRUCTION INFORMATION:
itiona .wor, .to e ertormed un, er t, is permit.— c. ec ;a apply:
HVAC . Gas Tank - - : Gas Piping - Shutters Q Windows Doors.
Z✓ Electric ❑✓ Plumbing Sprinklers Generator Roof
:Total Sq.-.Ft of Construction: 1,620 S . Ft: of first Floo,r::1,620
Cost of Construction:: 12,960.00 Utilities: Sewer Septic Building Height:
, OWNER/LESSEE:
CONTRACTOR:.
'Name WYNNE.BUILDING CORP.- :'
Name: WILLIAM.D. BRANTLEY
Address: 8000 SOUTH US,HWY. 1. SUITE 402
Company: WYYNE DEVELOPMENT-CORP.
Address:.8000 SOUTH US HWY. 1 SUITE 402
City:' PORT ST.. LUCIE State: FL
Zip Coder 34952... Fax: (772) 87867656
City: PORT.ST. LUGIE State; FL, .
Phone.No: (772) 878-5513
.Zip Code: 34952 Fax: (772) 878-7656
'E-Mail:
Phone:No.:(772) 87875513
:Fill in.fee simple Title Holder on.next page (if.different
E=Mail:,.
from the Owner•listed above)
State or County License,, DIH1-016128:- 29524
If value of construction is $2500 or more,. a RECORDED Notice of Commencement, is required.
SUPPLEMENTAL CONSTRUCTION. LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ -x Not -Applicable"
MORTGAGE COMPANY: .. ; . - x_. NotApplicable
Name:.sreye woods .
Name:.
Address:.:
Address:- . .:
City:. Stater
City: State:
Zip; Phone: c772j618-5644
Zip: Phone,.
FEE SIMPLE TITLE HOLD.ER:. x_ Not Applicable
BONDING COMPANY:. _ .: . - x . 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 holderto build the subject structure
is in with any applicable Home Owners Association rules, bylaws or -and covenants that may restrict or prohibit such -
Which conflict
structure. Please consult with your HomeOwnersAssociation and review your deed for any restrictions which may apply..
In consideration.of the granting of this requested permit,; I do hereby agree that l 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.bf Commencement must be-'rec6rded and posted on the jobs'ite
:before the.fi:rst inspection. Ifyou intend to obtain financing, co.nsU with lender or:an.attorney before
commencin work or recording: -our Notice of Commencement. -:
�.
= = Signature of Owner/ Lessee/Agent.
Signattire,of Contractor/License Hole .
RI
STATE OF FLOQA
' l
STATE OF
OF -IA
COUNTY OF
COUNTY
The for ing instru was acknowledged fore me
--this -day of � 20 �by
The forgoing instru ent was acknowledged before me
this C7�day of 20 by
J..
(Name of person acknowledging).
(Name.of person' acknowle ing) r.
i
(Si n ture of NotaryPubli State of Florida)
(SigriiyprEof Notary Pub'c-'State of Florida)
Personally Known. OR•Produced I. dentification
Personal) Known .. OR Produced Identification
y
.Type of Identification. Produced"
..
Type of Identification Produced .
Commission No..: Not4go is state of Florida
V-
1 Notary P o of Florida .
Commission No. 9101
JulieNIMycomrmissiori
JUlle Nln6ssi.
GG 638.942
c My comsio. 038942'
10/16/2020-
Revised-07/15/2014.
REVIEWS . -
FRONT-
ZONING
SUPERVISOR.
PLANS _
VEGETATION ":
. SEA TURTLE .
MANGROVE:
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COUNTER.
REVIEW
REVIEW: •.
REVIEW.
REVIEW-
= - REVIEW...
..REVIEW..: .
.DATE -
,COMPLETE
•INITIALS
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