HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO RE ACCEPTED
Date: Permit Number: 1 Q
J RECEOVED
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Building Permit Application JUN /3 2016
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: nxc 1.-.cam.r� 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 wor c to be Dertormed un er t s permit—check a app y:
i
1 HVAC `` OGeneratorGas Tank []GasPiping Shutters Windows/Doors
LJElectric LJ Plumbing QSprinklers ❑Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ -'Z�C Utilities. Sewer Septic Building Height:
OWNER/LESSEE: 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.
SUPPLEMENTAL CON STRUCTION`LIEN' AW IN _FORMATION
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:,
1 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
stricture.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
commencing work or recording our Notice of Commencement.
s
_Signature wraerJ Les Agent Signature of n ratio cense Holder
STATE OF FLORIDA STAT OF FLO DA
COUNTY OF SL Lode COUNTY OF sL 1 uae
The forgoig instrument was acknowledged before me The forgoipg of
was acknowledged before me
this X7 day of YY)A-Y . 20 Eby this-I"7 day of Yn �"f ,20 �by
Ma&m LyL-Wfl--I§- MaWMV Lyle wymre
(Name of person acknowledging) (Name of person acknowledging)
„ 16a'o.�
(Signature-of Nota ublic-State of Florida) (Signature of Nota blit-State of Florida)
Personally Known x OR Produced Identification Personally Known x' OR Produced Identification
Type of Identficat ffid Type of Identificat n 9, Ne
;:+ �; Ift Pu - tate of Florlda + ice:, Notary Publi�;�S�tP of Florida
Commission No. - . . y � e Commission No. =:•
+ _ y Comm. x r s Oct 2,2016 ;� y Comm. Oct 2,2016
=,<F oo- Commission#FF 015226 N:;Fos v�Q:0 Commission#.FF 015226
r c17 wougil 1411101121 Willy ARINSIC
Revised-07/15/2014
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