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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T' 1lQ Permit Number:
EtaLD
Building Permit Application NOV 9
Planning and Development Services
Building and Code Regulation Division PER!f lTTll\!C
2300 Virginia Avenue,Fort Pierce FL 34982
Wit. Lucie COL!n±y, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Other t
PROPOSED,IMPROVEMENT LOCATION:
Address: 3 KASSABA
Legal Description: SECTION 26/TOWNSHIP 36s, RANGE 40e
Property Tax ID#: 3414-501-1701-000/9 Lot No.3
Site Plan Name: SPANISH LAKES ONE Block No.
Project Name:
Setbacks Front 12' Back: 22' Right Side: 16'5" Left Side: 16'5"
DETAILED DESCRIPTION OF WORK:
DRIVEWAY- 30X12
250OPSI -4" THICKNESS
THE DRIVEWAY DOES NOT BUTT UP TO THE MOBILE HOME
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit–check all appy:
HVAC Gas Tank F]Gas Piping _Shutters Windows/Doors
Electric ❑ p
Plumbing nS rinklers Generator ❑ Roof
— U
Total Sq. Ft of Construction: 360 S . Ft.of First Floor:
Cost of Construction:$ 756.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name WYNNE BUILDING CORPORATION Name: MATTHEW LYLE WYNNE
Address:8000 SOUTH US HWY. 1 SUITE 402 Company: WYNNE DEVELOPMENT CORPORATION
City: PORT ST. LUCIE State:FL Address: 8000 SOUTH US HWY. 1 SUITE 402
Zip Code: 34952 Fax:(772)878-7656 City: PORT ST. LUCIE State:FL
Phone No.(772)878-5513 Zip Code: 34952 Fax: (772)878-7656
E-Mail: Phone No. (772)878-5513
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 8898
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: BRADEN&BRADEN Name:
Address:417 COCONUT AVE. Address:
City: STUART State: FL City: State:
Zip: 34996 Phone: (772)287-8258 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA _ STATE OF FLORIDA / .
COUNTY OF �7' LU -Le COUNTY OF S/ (�(�Gc.¢-
The forgoing instrumprit was acknowledged before me The forgoing instru ent was acknowledged before me
this�day of d ✓ 20�by this_,� day of�Vq M-ae.— 20_4 by
a P,(.J i(, i�h n e, Q r c) Lc41e lAlj,h n-P__
(Name of person acknowl ging) (Name of person acknowle Ing)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known_Y OR Produced Identification Personally Known_6 OR Produced Identification
Type of Identification
PProdpucceedL Type of Identification Produced
Commission No. (Se Commission No. �� 3
csta�of Flonda Public State
Ntary of Florida
v v o
43
Revised 07/1 Q r MY Mcnission f0978�3 a My Commission FF 9755
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