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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT :U
Date: i ' �' Permit Number:
r4 r_ 3 „ RECEDE®
Building permit Application JUN / 9 209
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue,Fort Pierce FL 34982 (//
Phone: (7 72)462-1553 Fax: (772)462••1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED it1lI'PROVEMEIVT LOCATION
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Address: 1509 NWBUTTONBUSH CICLE
Legal Description: HARBOUR RIDGE PLAT 13 BUTTONBUSH VILLAGE UNIT 7('OR 3763-2106)
Property Tax ID#: 4426-815-0014-000 Lot No.
Site Plan Name: Block No.
Project Name: RUSS LYONS
Setbacks Front Back: _ Right Side:_ Left Side:
DETAILED DESCRIPTION dF V�/OR`K pM g �
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COI�STRUCTIN=INFOR�r1ATION �'� �� � � `
,..,; ..,� ,,.: .'��, F .2 •o-,.c fin.;c .r... r;� � x.'X.h � -a Nf 1�C3LR aux ;
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Additional work to be oerrormecl un ert is permit—c i`F—ecd�al appy:
HVAC Gas Tank F]Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers L_I Generator �J Roof
'Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction:$ 4088.00 Utilities:Sewer 0Septic Building Height:
QWNER/LESSEE y �,a CONTRACTgR ; ,s
y ;
:. .. a . � .
.:
Name RUSSELL C LYONS Name: SCOTT BERMAN
Address: 1509 NW BUTTONBUSH CIRCLE Company: FLORIDA WINDOW AND DOOR
City: PALM CITY _State:F: Address: 7'108 FAIRWAY DRIVE#120
Zip Code:',34990 Fax: _ City: PALM BEACH GARDENS State:FL
Phone No.215-805-6319 _ _ Zip Code: 33418 Fax: 561-624-8037
E-Mail: Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: HOWARD@FLORIDAWINDOWANDDOOR.COM
from the Owner listed above) State or County License: CGC1509450 —
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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S1tPLENIE# TA 3CON�TRUCTQ11 [It I�A�,l1I iNtRi�lATlti � A 6� xXv � u
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: I _ Address:
City: I State: City: State:
Zip: Phone: Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address:I Address:_
City: I City:
Zip. ! Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Col nfy i�iakes 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 Tiny 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 Afnendments.
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
improverne to your prop A Notice of Commencement must be recorded and posted on the jobsite
be or irst inspection u intend to obtain financing, consult with lender or an attorney before
co cin workor re r ifig your Notice of Commencement.
__ s
i nature of Owner/L se Agent Signature- ractor/Lice -e Holder
STATE OF FLORISTATE OF i ,i COUNTY OF FLORIDA
��Z r✓Yi 32a?/.�
I ..OIlNTY OF >n — _ -- _
The for oing instrument w, s acknowledged before me The,forgoing,instrument was acknowledged before me
this day of ? 20 Jtby thisZY day ofAIDa 20 by
RUSSELL C LYONS SCOTT BERMAN
(Name of person acknowledging) (Name.of person acl<nijwiedging) —
(Signature o otary Public-State of Florida) Signature cif N ary Public-
�Sti'te.of Flo
Personally Known OR Produced Identification t� Personally Known OR Produced Identification _
Type of identification Produced f7/ Type:of Identification Produced "Ry ptl, tippJARDSHKOEF
c COMMISSION#EE 83079
Commission No. Commission No ea81abroeannof
PIKES:August 27,201,
Notary Public F a BarA d?u � tt+ctazy Sea:
ate o dri[d& 1.--
Revised 107/15/2014%W MY COMMISSION#FF 162268
I:Ynlrw-.qADI ember 2018 - —__� _—
REVIEWS, FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .COMPLETE
INITIALS � 1--
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