HomeMy WebLinkAboutBuilding Permit Application ALL APPUCABL INFq MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t Permit Number:
RECEIVED
wilding Permit Application JUN 13 2016
Planning and Development Services -
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 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: Pert of 3414501-1701-00019-Spanish Lakes One
'r.
Property Tax ID#• c Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: T.
Demolition of mobile horrrae
CONSTRUCTION INFORMATION:'
Additional work toe e orme under this permit—check a appy:
HVAC FI Gas Tank E]Gas Piping _Shutters Windows/Doors
LJ Electric F-1Plumbing'
Sprinklers C!Generator O Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$_ �bC1c Utilities:El Sewer 1 (Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameWynne Building Corporation Name, Matthew Lyle Wynne
Address:8000 South US 1, Suite 402 Company: Wynne Development Corporation
City: Port St.Lucie State:PL Address: 8000 South US 1, Suite 402
Zip Code: 34952 Fax:772-878-0224 City: Pert St.Lucie State-F•L
Phone No.772-878-5513 Zip Code 34952 Fax: 772-878-0224
E-Mail:sue@wynnebc.com Phone No. 772-878-5513
Fill in fee simple Title Holder on next page(if different E-Mail: sue@wynnebc.com
from the Owner listed above) State or County License: CGCO35999
If value of construction is$ZSOO or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIENa AWINFORMATION
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 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
commencing work or recording our Notice of Commencement.
s
_Signa of Ow"errLeiseel'Ahelk Signatur ntra cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sL u de COUNTY OF sL Luae
The forgojng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-.27 day of �M.0 , 20 1 b.by this 27 day of YYl�w( .20 11- by
Matthew Lyle Wym4 MatlhewLyfa Wynne
(Name of person acknowledging) (Name of person acknowledging)
/8 &'4'L
(Signature-of NotePublic-State of Florida) (Signature of Nota ublic-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identificati Type of Identification Pro
.,�""'%� DOROTHY ANN BASKIN ""
Commission No. =°��av Pve`�: Notary P(M81)State of Florida Commission No. ;2°.PRr PUe`�; No(�g�I�lic"' DOROTHY AS ate oS Florida
•; . My Comm.Expires Oct 2,2016 =•. •= My Comm.Expires.Oct2,.2016
o;S Commission Ai FF 015226 Ny. '�:� Commission
°� "' Bonded Through National Notary Assn. `" ��•'''
g y Bonded Through National Notary Assn.
Revised-07/15/
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DATE
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INITIALS