HomeMy WebLinkAboutChange of Contractor R E C E I t _3 ,SPR ) 0 2017
- PLANNING &DEVELOPMENT SERVICES
-'' - A BUILDING.& ZONING DIVISION
s m
2300 VIRGINIA AVE
- -- - FORT PIERCE,FL 34982,
(772)462-1553 FAX 462-1578
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized by the property owner,
and the new contractor ofrecord for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C -Change-out). A recorded copy must be submitted prior to
commencing any work.There is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form.There is a$50.00 fee for the Change of Sub-
Contractor.
CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
(A
Date: Permit Number: -
Site Address: 5010 SANIBEL AVE,APT A
PAUL ZAKHARY State License CBC1 255393 SLC License
Original GC,subcontractor or owner/builder
MICHAEL CONRAN State LicenseCBC1261632 SLC License
New GC,subcontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
costs,fees or damages arising from any and all claims of action for any reason,whit may arise as a result of this change of
ontractor/subco ctor or tante tion of rmit.A permit cannot be c c ed' ork as been performed.
S GN OF OWNER(oro er lder). SIGNATU GENERAL CO TOR(or new GC,as applicable)
PRINT NAME JU C�• ?W lq PRINT NAME _� � rG11��
State of Florida County of State of Florida,County of St Lucie County
The following instrument was aclatowledged before me this The following instrument was acknowledged before me this
La-"Aday of ;N .201-1,by5�4 _ a�day of Q t i�\ 20A byyn;"fit
L +.O t3 r4v.1 who is personally known tome C Omn C ®vn who is personally known to
or to has produced p1' as ID. a or who has produced L p L as ID.
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Lure of Notary Date ileatt re of
" "�'''• DEANNAMARIE GNENS
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,o.�xo,,� TRACI A.PRICE '_ MY COMMISSION#GG 022023
Revised 04/15/16 _2: °+c= Notary Public State of Florida 3� ;a? EXPIRES:December l6,2020
PF My Comm.Expires Nov 20,2017; .,e�FF�o?•• Bonded ThruNotary Public
Undenvriters
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OF��o? Commission # FF 072215
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RECEJT.=D AP
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
Building Permit ApPlical ion
Planning and Development Services
'Building and Code.Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)4, 62-1553 Fax:(772)462-157$ Commercial . .Residential X
PERMIT APPLICATION FOR: Window/door-
PROPOSED IMPROUEM.E'NT C4.CAT1�3N ; ...
2
Address: 5010 SANIBEL AVE,APT A
Legal Description: LAKEVVOOD PARK-UNIT 12-A BLK 175 LOT 5,
Property Tax ID#.'1:301=615-0158-0100-T Lot:No.5
Site Plan Name: Block No. 175
Project Name: CSC INVESTMENTS
Setbacks Front. Hack: Right Side: Left Side:
DETAII ED DESCRIPTION QF WORK
REPLACE (3) EXTERIOR DOORS
Ct?NSTRUCTIO!N,INFQRMi47-10.'N -
Additional work .toe e Orme under tispermit—c ec a appy:
11HVAC �'Gas Tank bas Piping _Shutters ZWindows/Doors
r]Electric Q Plumbing OSprinklers liGenerator F]Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1100.00 Utilities:I Sewer FISeptic Building Height:
OW N ESSEE CONTRACTOR
Name JOC PROPERTIES INC Name: MICHAEL CONRAN,
Address:1001 S.E MONTEREY RD Company`. CONTRACTOR SERVICES OF SOUTH FLORIDA LCC
City: STUART State:FL Address: 1001 S.E MONTEREY RD
Zip Code: 34994 Fax: City: STUART State:FL
Phone No.7727085763� Zip Code: 34994 Fax:
E-Mail:JUDYCONRAN@GMALL.COM Phone No. 7723613227
Fill in fee simple Title Holder on next page(if different E-Mail:SFCONTRACTOR@YAHOO.COM
from the Owner listed above) State or County License: CBC1261632
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
RECEIV':p APR (� 70,7
SU_RPLEM,ENVTAI_CONSTRUCTION LIENIAW INFQ M'ATION.
MORTGAGE COMPANYNApplicabler i
DESIGNER/ENGINEER: _Not Applicable
: ot
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 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 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 fallowing 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
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before,the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
s
signature"6f Owner/Le 5-eMiC�ractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 3t. L 13 c.%0
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this'_day of,A t C i4 20 )3this 0 day of*%!t t`Z\ .20 )by
o,,-t-N C d v,; �.4N
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida} (Signature of Notary Pu ic-State of Florida}
Personally Known OR Produced Personally Known OR Produced Identification
Type of Identification P Ng Type of Identific w .I�.•• ' do
•tir a --r^r
TA NRURRRR
MY COMMISSION#GG 022023 ,,•1,:,.'-•, DEANNA MARIE GIVENS
Commission No. '� EX )Dewrnber16,2020 Commission No. - COMMISSi(Y4Af 022023
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Banded Thru Notary public;Underwr tars ;,: - PIRES:December 6,2020
-•.;oF��Q.•` Bonded Thru Notary Public underwriters
Revised 47/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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