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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: y 1T`� Permit Number: `roo ® RECEW'_7D APR 122016 -` 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 „l,^ PROPOSED IMPROVEMENT LOCATION: Address: Z< y' 1�c�s-� 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 Side:, Left Side: [DETAILED DESCRIPTION OF WORK: Demolition of mobile home CONSTRUCTION INFORMATION: Additional work toe oerformed under this permit—check a a appy: HVAC1:1 Gas Tank ❑Gas Piping _Shutters Windows/Doors Electric E]Plumbing Sprinklers E]Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ "S�?=C7Utilities: Sewer DSeptic Building Height: OWN ERAESSEE: CONTRACTOR: Name Wynne 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. r SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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: 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 su ject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restri or prohibit such structure.Please consult with your Home Owners Associa ion and review your deed for any restrictions which m y apply. In consideration of the granting of this requested perm',I do hereby agree that I will,in all respects,perform t work in accordance with the approved plans,the Florida Bui Ing Codes and St.Lucie County Amendments. The following building permit applications are exem from undergoing a full concurrency review:room add" ons, accessory structures,swimming pools,fences,wal ,signs,screen rooms and accessory uses to another no esidential use WARNING TO OWNER:Your failure to ord a Notice of Commencement may result in yo r paying twice for improvements to your property.A N icE,of Commencement must be recorded and sted on the jobsite before the first inspection. If you 1 end to obtain financing,consult with lend or attorney before commencingwork or r cordin ur Notice of Commencement. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder 4 STATE OF FLORIDA STATE OF FLORIDA COUNTY OF s-utcle COUNTY OF s-Lucie The fo S'ng instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of t 20 by this`day of 20 by Matthew Lyle WyruJ- Ma chew Lyfe Wynne (Name of pe n acknowledging)' (Name of p�on acknowledging) Signa ure-of Notary Public-State of FI a) ,( ture of Notary Pub ic-S ate of r da) Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Produced _ Type of Identification Produced < es'•,, SUSAN Ml�GE,,E.,' Commission No. :?' �= 9MMISS10ON7647 Commission No. (Seal) =a`• a€ EXPIRES:February 23,2019 -.; NnhqPiffilip k' SUSAN MAGEE Banded ThriiY UUMMISSION#FF 187647 Revised Q7/1512014 `q4 EXPIRES:February 23,2019 RB,S\ Bonded Thru Notary Public Undervrilers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS