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ALLAPPLICABW INFO MUST BE COMPLETED FOR APPLICATION TO,BE ACCEPTED
Date: 161Permit Number:
,., B, ildin ,Permit A lic
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Plonning ojn0ndDeyelopmentServices J&ECEIVED
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Buildingpbode Regulation Division
2300*6rg i ,Avenue,Fort Plerce FL 34982,Phone ( 7?}46.2-1553. Fax:(772}4b2 3578 Commercial a bY.l
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PERMIT APPICATIQN-FOR: '
To'Setec#from dropbox, click arra
PROPOSED`IMPROUEIVIENT:LOC�ATO$N > 5:, `, 3 :' '
Address:.: 0 b 1V% ct 0..t.. k .Co U
Legal Descriptrop C_t 66 bN t t IV C.0
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Pr6perty Tax ID#i �7���3 -607-7— Qad "� Lot No.
Site Pla_R.'Ne�� Block No.
Project Name- j s
Setbacks-
A_ rant Back Right Side: LeftSlde: .
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CONSTRst1 =a,t4N INF, _Q "';!"M! Y h E'.
d _it ona rtdor 4 to.be clertormej :pan erl. is perm, c ec �a . app y
LC�HVAC1 Gas Tank ;'', I Gas Piping _Shutters Windows/Doors
Electric , Plumbing I ! Sprinklers Generator. Roof
Total Sq,'.Ft of.Gonstruetion: S .Ft.of First Floor.
Cost oftbn�truction:$ t 2�. �� J i utilities:0 Sewer u Septic Building Height:
'40" LESSEE, C} ITR'ACTOR },
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Name S & `i i - -Name•
Aeter'Ndaiaro lif
Address: it r3 i vt t ` . QU Company; Lowes Nome Centers,LLC
l pir tQ : RG B 781
ox 993
City: -TE Q t State: Address:
Zip Code F/ax: .f. City: Orlando State FC
Phone No..i i`. d L' Z?"t l S ZipCode• 32878-1993 Fax
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E-Mail l. Phone No.
-Fill In fee sign ie Title Bolder on next,page{.if different E-Mail: .,
from the Owner listed above) ? State or County License CGC1508417
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If value ofrco'nstuction-ls$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPi:ENii�tii iC tt NSTRUCTiO'i�1LiEN ' `WTINFORNiATlDN'N i °' .t ! I' f
...z.. -._,-. ,s,.„,�#il..t. - ?:F_'a., �'?:t�-.4ti .,�Yi.„fn.e,..-x�srsi:.Ll::r.sk:, �p�",•'a...'n .'.. t«i,.�.S,rt'.:;f_.
DESIGNER/ENG{{NEER: Not=Applicable- f1AORTGAGE COMPANY: Not Applicable` '
Name Name. #
Address 3 I `!. Address: k �:
City: i State. City: State I
Zip 3, Phone: Zip: Rhone:
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EE SIMPI E 1T E HOLDER: U0. �Applica.ble 130NDiNG;CQM ANY: Not Applicable
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Name -- Name: _� �
•Address:' _ ` 11 Address: I. j
City: !! 4 City
Zip: 11 Rhone: 1. Zip: Phone: I•. F'
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I certbfy Chaim wl rk or installation has commenced prior to toe issuance of a permit
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St.Lucie Count ,m kes no'representationtthat is grant#ng;a permit wlll:authorize.the permiE hcilde to build the subject structure . �•'° i
which is idito-N c ith anjr applicable HamelOwners Association rules,.bylaws'prand covenants that may restrict or prohib#trsuch i
structure?Please nsuit-with your Home,OV+iners Associi tion'and review your rleedtfor':any restrictions which may apply. a
I consideratio#r)o the granting of this requested permit,Ido hereby agree that I will,.I`all respects,perform the work ; li
in accordance if the'app.oved plans,the kFlorida,Building Codes and St.Lucie.`County Amendme s.
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The follow3ng1 �l ing permit applications are:_exempt from undergoing a full concurre 'cy revs :r om additions, .
accesso4li G�$ur s,swimming Pools,fences;watts,signs,screen rooms and act uses o ano er ngn-residential use
WARNING TO ,` M Your f ur tg,Record.a Notice of Commencement'rit a -result your pa ing:twice for �
improvements y r.prop _ .At atice of.Commencement must be rec' retell a d post o the Obsite ;
before tie firs sp tion f you m end to obtain financing,consul with' ender o an.a me before 3
coriaamenci ' °rk o rec din o' Nottce;of Commencement
Signature of net/lessee/Agent I" Signature of C ,tra for/License H der
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STATE;OF_FL IDA. STATE OFtF ,'RI A 1 '
COUNTY OF .R. ce h.#' COUNTY U oRari
" :The for oin i stru,:ent' w,as acknowledged before me:
• The fo�mg i s� ment w�s.acknowiedg� efore me � g i
Chi$7r' di} C� 20 t =6} this�/ d2 f •� 20 by i
LLQ. f( (
PETER A CAFAftl!! - i i PETER A CAFI�_O iII ,
acknow,edging:) t (Name of person a knowletlg )
T Ell
( gnatu dit o aryPublic-Stafe f FI rirda;) I gnature,o, ota` 'Public State of FI rids f
Persona ly,Krtb X OR Produced Identification Personally Known x OR Produced Identification:
Type of ldentific tion Produced t Type of Idenntificati'on Produced
;. FF NtG4Z i Commssidn•'Na F�,f)8 7>
Commissio>�to: N t#NcStateoiPitxfd� H
oteiY MGMSte W Frorkie
li tteri M•RicCstiaitl '� ` Kati M Ricceboni I
fi I an �xplret<t}8{Y8t202a orn Explre><tlst28=20
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REVIEWS fi" FRONT ZONINGS SUF?ERVISOR PLANS 1(EGETATION SEA TURTLE MANGROVE ;
COUNTER REVIEW, REVIEW REVIEW REVIEW' REVIEW REVIEW' I ;:
DATE i,�!;
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