HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUS BE /COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a�i . ) 3 SCANNED Permit Number:
By
St. Lucie County
Building Permit Applicatio
11 Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553Fax: (772) 462-1578 Commercial X
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PERMIT APPLICATION FOR: Other III
I PROPOSED IMPROVEMENT LOCATION:
Address: 1 LAS CASITAS
Legal Description: EAST 1/2 OF SECTION 1'- TOWNSHIP 34S - RANGE 39E
PropertyTax ID #: 1301-111-0001-000-5 Lot No.
Site Plan Name: COUNTRY CLUB VILLAGE Block No.
Project Name:
Setbacks Front24970" Back:42'59' Right Side:
I DETAILED DESCRIPTION OF WORK:
Pavilion to be built on a 10 x 20 concrete pad
Left Side:
CONSTRUCTION INFORMATION: III
I�HVAC Gas Tank
Electric D Plumbing
Total Sq. Ft of Construction: 200
Cost of Construction: $ 1,120.00
Shutters ❑ Windows/Doors
Generator Z Roof
S Ft. of First Floor: 200
Utilities:nSewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WYNNE BUILDINGDEPARTMENTName:
MATTHEW LYLE WYNNE
Address: 8000 SOUTH US HWY. 1 - SUITE 402
Company: WYNNE DEVELOPMENT CORPORATION
Citya PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: (772) 878-7656
Phone No. (772) 878-5513
Address: 8000 SOUTH US HWY. 1 - SUITE 402
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: (772) 878-7656
Phone No. (772) 878-5513
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License: 08898
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
Name:
MORTGAGE COMPANY: x_ Not Applicable
Name: _
Address:
Address:
City: State:
Zip: _ Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance ofa 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
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
S
_ Signature of Owner/ Lessee/Agent Signature of Cont r Icense Holder
STATE OF FLOftIDA �� tC ` STATE OF FLORI L
COUNTY OF ' t COUNTY OF 1 bt e �—Q-
The forgoing instr n wa a knowledged efore me
this day of 20 i b by
(Name of person acknowledgitYg )^
The forgoing instr ent was a knowledge efore me
this �5dayof na 20 11 by
Ro (A-ez-4_)' 1__L4 1� l �
(Name of per$on.acknowledging
(SigrWure of -Notary Pub' State of Florida) (Sitr `ature of Notary
'Public- State of Florida )
Personally Known 7OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Nc 60q blicStateof Florida Commission No. -
Julle NlnaSsl - Notary Pu Iic I to of Fbdda
a My Commission GG 038942 ;P �' Julie NInaSSI
Revised 07/15/2014
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