HomeMy WebLinkAboutHumphries permit-need to resubmit, updateAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12I1612021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Judith Humphries
PROPOSED IMPROVEMENT LOCATION:
Address: 10680 s Ocean Dr Apt 107 Jensen Beach, FL 34957
Property Tax ID #: 45115160014006 Lot No.
Site Plan Name: Island Crest Condominium Block No.
Project Name: Judith Humphries
DETAILED DESCRIPTION OF WORK:
Remove and Replace windows and doors with impact glass
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors Pond
Electric _ Plumbing _ Sprinklers —Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1 2 q`� •19-0 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Judith Humphries
Name: Cliff Fischer
Address: 10680 s ocean Dr Apt 107
Company: Monterey Glass
city: Jensen Beach State: FL
Zip Code: 34957 Fax: 772-283-1919
Phone No. 772-521-425C E-
Address: 851 se Monterey Rd
City: Stuart State: FL
Zip Code: 34994 Fax: 772-283-1919
Phone No 772-521-4250
Mail: c1ift.fischer@yahoocom
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail cliff.fischer@yahoo.com
State or County License 25686
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
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.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 {raying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with fender or an attornev before commencine work or recording vnur NnfirP of Cmmn,PnramPnt
Signature of Owner/ Lessee/Contractor as Agent
for Owner
STATE OF FLORIDA
COUNTY OF
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Swor to (or affirmed) and subscribed before
me of X Physical Presence or Online Notarization
this.12 2Q1L by
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Name of person making statement.
Personally Known OR Produced Identification X
Type of Identification Produced DL
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