HomeMy WebLinkAboutBuilding Permit Application i.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Q
Date: Permit Number:
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: Port St. Lucie 34952
Legal Description. Part of 3414-501-170)-000/9-Span- h Lakes One
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: s
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Demolition of mobile horde
CONSTRUCTION INFORMATION: i
Additional work to be pertormed under this permit—check all appy:
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1 HVAC Gas Tank []Gas'Piping _Shutters Windows/Doors
L_J Electric M Plumbing Sprinklers o Generator Q Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ `-r"C 7�' Utilities:)=)Sewer nSeptic 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 Cotte: 84952 Fax:772-878-0224 � City: Port St.Lucie- State-'FL
Phone No.772-878-5513 Zip Code: 34952 'r 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-
I value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:,' -
DESIGhIER/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:
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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,l 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 io obtain financing,consult with,lender or an attorney before
commencing work or recording our Notice of Commencement.
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5' atur Owner/Lessee/Agent Sign=OFLORIDA
or/License Holder
STATE OF FLORIDA STA
COUNTY OF SLLude COUNTY OF s-Lucie
The forgo'ng instrument was acknowledged before me The forgoirtg instrument was acknowledged before me
this1A _day of M A `! , 20 LL by thisp27�fd"a-y of YYI&1 ,20 6 by
Matthew Lyle Wym MOM—Lyle Wy—
(Name of person acknowledging) (Name of person acknowledging)
(Signature-of Nota ublic-State of Florida) (Signature of Nota P blic-State of Florida)
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identifica Type of Identification Pr ucer
,�tna•PE:79
NN BASKIN
Commission No. ?•2• e`� Notary Pu ate of Florida Commission No. �. NotaState of Florida
.•_ y Comm.Expires Oct 2,2016 o. es Oct 2,2016Commission#FF 015226 '•;�soFF 015226Bonded Through atlona otary sun. onal Notary Assn.
Revised07/15
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION, SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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