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All APPLICABLE INFO MUST BE COMPLEJED FOR APPLICATION -TO -BE -ACCEPTED
i 1 Date: k 0 - Z� • • A �5� Permit Number: l - 602,
o% RECEIVED
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ocr 1� 5 2019
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o Building Permit Application Permitting Department
St. Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349821
Phone: (772) 462-1553 Fax: (772) 462�'�-1578 Commercial Residential x
PERMITTYPE:«.014rhom�e set up
PROPOSED 111ltPROUEAItE;NT
LOCItUN } Y> 4� ; -
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Address: southwind trail ft peirce 1i 34951 — ,
Property Tax ID #: 1407-433-0015-000-C Lot No.
Site Plan Name: Block No.
Project Name: grace blair cote
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DETAILED DESCRIPTION OF°WORK .t 'SK, " N F
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` Yv d '. `k '•. ' Jj 9 Y'✓• 341 ,.' }SS y .zA.. ,,rt`
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dA-home set up /plumbing/electric/rriechanicial
6c 1300'fUz J
C ;PrC. b 5-1 L AP
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Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank .' _ Gas Piping _ Shutters _ Windows/Doors
\Electric X Plumbing 4 _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ 50000 Utilities: —Sewer _ Septic Building Height:
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OWNER/LESSEE r 4� h t R 3 $ F , G
,
,XONTR_ACTO_R�'
Name grace blaircoleI-
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Addressaame as above
Company:ku` � �/) US - ®Uy I Coil L(,
City: State: _
Address:209 s frontage rd
Zip Code: Fax: I
City: plantcity State•fl
Phone No. 772-631-8976 786-277-2CI;71
Zip Code: 33563 Fax:
E-MailYl e ✓ ' - J 4eA; —
Phone N0813-707-8888 1g' 1, 3 �(o�'�j ()
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Fill in fee simple Title Holder on next page ( f different
E-Maii.cherieh@tampabay.rr.com
from the Owner listed, above)
State or County License!`` %
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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1 1 -.;.' .1 ANY! Not I Applicable
DESIGNER/ENGINEER.'`Apolic6ble MORTGAGE COMPANY: Nof7
Name:
Name: Address:' State:
Address:-, State:- city'.
City: Phone:
Zip: Phone
Not Applicable
FEE SIMPLE TITLE HOLDER: Not Applicable. BONDING COMPANY:
Name:
Name:, Address:
rpss':
is
Address: City:
City: Zip: Phone -
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to. 'obtain a -permit to do the work and installation as indicated.
I certify -that no work or installation has commenced prior to the issuance of a permit
pp:
structure
�r to build the s
ntation that is granting a permit will authorize theg6rmit,holde . rict or prohibit such
St. Lucie Coun makes no-represe i rules, bylaws or an . covenants that may rest apply.
ictions which may
which is in conflictwith any applicable Home Owners Associationatior
structure. Please consultwith your Horne,OwnersAssociationand review your deed for any, restri
and
that I will, in all.respects, perform the work
t
In consideration of the granting of this requested permit, I.do here. 'Lucie Coun Am
in accordance with the approved' pja'hs, th-e Florida BuildinglCodes and St, y efidments.,
ions,
The following building.perrhit appare exemt from undergoing a full con.currency review: room addit'
swimming poolicationsls, fences, wa(Is, psignsi screen rooms . and, accessory uses another non -residential use
a -
accessory structures, ry RESULT . T IN YOUR.-PAYI.NG
RE TO RECORD A'NO110E OF COMMENCEMENT MAY
"WARNING TO, OWNER: YOUR FAILURE MENCtMENT, MU!gi.- AND
A NOTICE O?4 SULT,
TWICE FOR -IMPROVEMENTS TO -YOUR. NTEND TO OBTAIN FINANCINq,- 117-ON
OU I
POSTED ON -THE .408 SITE BEFORE THE FIRST INSPECTION. IF Y.
RECORDING YOUR NO CE,OF COMMENCEMENT."
of owner/
as
STATE OF FLORI ' DA
COUNTY OF
The f ing instruLnenVw acknowledged -before me
orgol this,M day of 20by
L
_Name of person making state ent.
Personally Known making
Identification
ire.of identification
ObNAN' �SAN0jyi-1dANN6W
NOWY P afe 6
Bonoed through National Not
commi,
REVIEWS FRONT NINE
COUNTER VIEW
DATE
RECEIVED
DATE.
COMPLETED
Signature of Contract6r/License Ho Ider
STATE OF •FLORIDA
COUNTY.QV.
The:for o. trument s acknowledged f 'goirig ins... before me
26-6 by
thls.,�O day of
Name,of person' .makin
Tstatement:
.,
Personally Known OR Produced Identification
Type,, -1 n
Prodd
NotAry P of, "
Public - State Floridaw
Commissi'dn # GGA36068
1 Jan Comm. E 20 1
(sign urd' aF -
commission
SUPERVISOR
I PLANS VEGETATION
REVIEW REVIEW REVIEW
:WTU RTI�E'
REVIEW
MANGROVE
REVIEW