HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: \ 1 S �� Permit Number:
RECEIVED JAN 0 5 1016
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address,� CS- Port St. Lucie 34952
Legal Description: Part of 3414-501-1701-00019-Spanish Lakes One
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Sider Left Side:
DETAILED DESCRIPTION OF WORK;
Demolition of mobile home
CONSTRUCTION INFORMATION-
Additional
NFORMATION:A itiona work toe performed under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters l]Windows/Doors
FlElectric F�Plumbing Sprinklers 11 Generator. EIRoof
Total Sq. Ft of Construction: S . Ft.of First Floor:
C70
Cost of Construction:$ Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE: . CONTRACTOR:,
NameWynne Building Corporation Name: Matthew Lyle Wynne
Address:8000 South US 1, Suite 402 Company: Wynne Development Corporation
City: Port St. Lucie State:FL Address: 8000 South US 1,Suite 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
Fill 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
IDES96MEIR/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:
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 holder to build the subject str cture
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or proh it such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration of the granting of this requested permit,I do hereby agree that 1 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 uncle ing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,sere rooms and accessory uses to another non-reside tal use
WARNING TO OWNER:Your failure to Record a No 'ce of Commencement may result in your payi twice for
improvements to your property.A Notice.of C mencement must be recorded and sted n the jobs
before the first inspection. If you i tendo ain financing, consult with lender or att ney before
commencing work or recordin r Not' of Commencement. i
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
A
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SL Lucie COUNTY OF st-Lucie
The fo_rgc Ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thist`. day of:: _� _ . 20 Eby this ay of-_ �►,20\� by
MaMew Lyle Wynne- Matthew Lyle Wymre
(Name of person acknowledging). (Name of p n acknowledging)
i
i
tgnature-of Notary Public-State o tda) (Signature of Notary Public-Stat of lorid
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ,�. Yrv.!-�
Ig�PAGEE Commission No.--- - (Seal)
_. :A MY COMMISSION#FF 187647
EXPIRES:February 23,2019 ,qt""r.^G''•. SUSMMAGEE
�Rf ane ru ary u e ers t; ;t: MT UM=UN#ff1
Revised 07/15/201 EXPIRES:February 23,2019
RF��F� Bonded Thtu Notary PubGo Und87647
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