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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ED
RECEIV
Building Permit Application JAN 1 g 2017
Planning and Development Services PERMIT I ING
Building and Code Regulation Division St. Lucic County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-15.78 Commercial Residential X
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 5 CASA RIO
Legal Description: SECTION 26/TOWNSHIP 36s/RANGE 40e
Property Tax ID#: 3414-501-1701-000/9 Lot No.5
Site Plan Name: SPANISH LAKES ONE Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE WALL STUDS, INSULATION, PLYWOOD. ALSO REPLACING FLOOR JOISTS.
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under t is permit—check all apply:
L�HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
❑G Electric ❑ Plumbing ❑Sprinklers enerator ❑ Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1,100.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: Matthew Lyle Wynne
Address:8000 South US Hwy. 1 Suite 402 Company: Wynne Development Corp.
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: CGC03599
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: _Not Applicable
Name: Steve Wood Name:
Address:950 Sultan Dr Address:
City: Port St.Lucie State: FL. City: State:
Zip: 34953 Phone: (772)878a324 Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Pho e: Zip: Phone:
I certify that no work or install ion has commenced prior to the issuance of a permit.
St.Lucie County makes no repre ntation that is granting a permit will authorize the permit hold r to build the subject structure
which is in conflict with any appli able Home Owners Association rules, bylaws or and covenants t at may restrict or prohibit such
structure.Please consult with you Home Owners Association and review your deed for any restri ions which may apply.
In consideration of the granting of his requested permit,I do hereby agree that I will,in all respec s, perform the work
in accordance with the approved p ans,the Florida Building Codes and St.Lucie County Amendme ts.
The following building permit appli ations are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming po Is,fences,walls,signs,screen rooms and accessory uses to ark ther non-residential use
WARNING TO OW ER:Your ailure to Record a Notice of Commencement may resu t in your paying twice for
improvements to ur prop ty.A Notice of Commencement must be r( rded nd posted on the jobsite
before the first in ection. I you intend to obtain financing, consult IT/encle or an attorney before
commencing�o or recor in our Notice of Commencement.
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_Signature of w r/L s /Agent Signature of C ntr r/License Holder
STATE OF ORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF ST /.ti c,,F
The forggo�ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 116 day of �',g-Oy"Ase!j 20 ►'?by this l(o '&day of ,.JA"u A y ,20 47 by
CycE INyNNG� //V,47 -WEIu L�/LE 6,u Y'v Nr
(Name of person acknowledging) (Name of person acknowledging)
(Signature of NqJfry Public-State of Florida) (Signature of Nota ublic-State of Florida)
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Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
<:�:?;''', DOROTH�YC.-,A,_,N,1'N BASKIN '•'GF�''�%
Commission No. �: ' COMMI9l ,GCi030145 Commission N `� 'Yer'•: DOROTHYANNI�I�
eaMMISSION# 145
EXPIRES:October 2,2020 ;cr EXPIRES;October 2,2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE D.(
COMPLETE �1
INITIALS �
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