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HomeMy WebLinkAboutChange of Contractor i PERMIT# ��a ISSUE DATE I _ PLANNING& DEVELOPMENT SERVICES Building& Code Compliance Division • • o ___...-_,...._...,__..-.._-.--_..._�_.._.._. .-• BUILDING PERAM SUB-CONTRACTOR AGREEMENT �(L � have agreed to be (Co Name/IndividualNume) // the V t 4" Sub-contractor for 4OG 4f/-44A / GI.5-/— (Type of Trade) (Primary Contractor) For the project located at (0 �Cvt f'1 (.I V 0 V 0 O (Project Street Address Property Tax ID#) It is understood that, if there is any change of status regarding our participation with the above mentioned project,the Building and Code Regulation Division of St.Lucie County will be advised pursuant to the filing of a Change of Sub-contractor notice. I CONTRACTOR SIGNATURE(Qualifier) REEZ6NTRACTok SIGNATURE(Qualifier) Jon4kun- Me jr, %. PRINT NAME PRINT NAME I Z I COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER State of Florida,County off 94-6eC e1 State of Florida,County of S JeGe i The foregoing mstnment was dowd before me this day of The foregoing mstnmient was signed before me this �/-5 delay of 21W,by " a.< 2t1 by E r IYJ, who is 4rsonally known or has produced a who is pe y own bas produced a as identificati as identificati JOSE FRESNILLOState of Florid$ =* Y Public e- fission # GG 272747 Signature of No Public otpa '�s',, S E F I L L O Signature:of Noffi blic =;',� .g ,a ��-State of Florida-Notary Public %pFft°. MY Commission Expires =' *= '""�� December 22, 2022 Commission # GG 272747 My Commission Expires December P 22, Nau>te of Notary Public 2022 Print Naine of Notary Public rint Revised 11/16/2016 PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION • 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 of record 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 co Jmm�ncing 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 thb owner and qualifier of record. There is no fee for cancellation of the permit. C� .�Zpj 2/ y l 0"5'd Date: J � l Permit Number: � Site Address: v 1,v,-x4A.,4`t /v t State License(;11. 4 KK 3 SLC License l g Original)GC,subcontractor or owner uilder pi r,6i' LCG State License CFC 14 3 0 S 14 SLC License New GC,subcontractor Reason for Cancellation oul -6 c`t 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,which may arise as a result of this change of contractor/subcontractor or cancellation of permit.A permit cannot be cancelled if work has been performed. -�Z� �),A�, SIGNATURE OF OWNER owner/builder) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable) PRINT NAME 1�_, SyS� PRINT NAME State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County The following instrument was acknowledged before me this The following instrument was acknowledged before me this _1-3 day of !} 20AL,by day of 20_ by who is rsonp ally!mows to me who is personally known to or who ha duced as ID, me or who has produced as ID. 091/ Signature o o ry, Date Signature of Notary Date Revised 04/15/16 o•``aY'�" JOSE FRESNILLO State of Florida-Notary Public =* *_ Commission # GG 272747 P,� My Commission Expires December 22, 2022 i m Planning & Development Services Building &Code Regulation Division ® 2300 Virginia Ave o6 Fort Pierce, FL 34982 - -- - 772-462-2172 Fax 772-462-6443 CERTIFICATE OF TERMITE TREATMENT CONSTRUCTION SOIL TREATMENT PERMIT # : 2,001-D)00 JOB ADDRESS: 6801 Penny Ln, Fort Pierce, FL 34951 BUILDER/CONTRACTOR: ------------------------------------- PEST CONTROL ;CONTRACTOR: Tru*'s Pest Control_ _ _ _ _____ PEST CONTROL LICENSE #; J13183203 — We, the undersigned, hereby certify that we have pretreated the above described construction for .subterranean termites in accordance with the standards of the National Pest Control Association. Square feet if area treated: 1750 Chemicals used: crosscheck Percentage of solution: 0.06% Total gallons used: 150 Date of Treatment: 05/13/21 _ Time of Treatment: 8:oo am Footing Slab 1st Treatment 18t Treatment Re-Treat Re-Treat __Driveway Pools i 1st Treatment 1st Treatment Re-Treat Re-Treat ___—Other XXX Perimeter for Final Inspection 1st Treatment - Re-Treat j Signature of Exterminator Note: There must be a completed form for each required treatment or re-treatment and this form must be on the job site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-inspection fee charged. FBC104.2.6 Certificate of Protective Treatment for prevention of termites. A weather resistant jobsite posting board shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed, providing a copy for the person the permit is issued to and another copy for the building permit files. The Treatment Certificate sha//provide the product used, identity of the applicator, time and date of the treatment, site location, area treated, chemical used, percent concentration and number of gallons used, to establish a verifiable record of protective treatmentt, if the soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on the electrical panel box cover, listing all the treatments and dates of applications. i Planning and Development Services Building and Code Regulations { 2300 Virginia Avenue " Fort Pierce,FL 34983 ,ry ° © 772-462-1553 ` Fax 772-462-6443 TEMPORARY EARLY POWER RELEASE i (Name of Tenant or Owner) 1 The Tenant or Owner requests St Lucie County Development Services Department to release the electrical power at' GRd f �ey LA , (address, including suite number, as posted on the electric meter and the building) for building permit # 2cll-0 , for the purpose of construction and testing building systems, including air conditioning, refrigeration, lighting,power and control circuits with the following stipulations: 1. Incomplete or untested circuits are NOT to be energized without properly licensed electrical personnel on the jobsite and no systems are to remain energized beyond. the 1esfirig/temporary purpose without proper inspection by the St Lucie County Building Department appropriately licensed person(s). 2.All panels and disconnects not in use must be locked in the"OFF"position or-fuses removed. 3.Proper procedures for lockout/tagout must be in place. 4.The electrical equipment room(where applicable)will remain locked at all times with the key in the possession of the electrical contractor. 5. All final inspections relative to the closeout of this project must be requested and passed in a timely manner as determined by the Electrical Inspector and/or the Building Official. 6.The building may not be occupied before a Certificate of Occupancy(C.O.)is issued. 7.No stocking of materials,other than those required for construction is permitted by this agreement 8.No on-site occupancy or training of personnel employed by the occupant,business entity or owner is permitted by this agreement 9.No furniture,racks,furnishings or other personal or corporate property is permitted on site by this agreement. 10. Construction power remains covered by the requirements for GFCI protection and all other requirements of the governing Codes,see National Electrical Code(NEC)Article 590. i Violation of this agreement may result in the immediate termination of the electrical power without prior notice or warning to the affected parties. This form requires all of the following signatures prior to power being released.The undersigned acknowledge that the operation of air conditioning equipment while construction is in progress may create or increase the risk of contamination or premature failure of the equipment. The undersigned acknowledges the above listed stipulations, agrees to the terms of this agreement and agrees to hold St Lucie County harmless from any damages that may arise as a result of the jrelease of power to the premises. The undersigned hereby requests power to be released for this project.This form does not guarantee power,which is at the discretion and control of the electrical utility. i 1 Q Important: The occupant of the property (or other appropriate party) shall have made proper application to the electric utility, paid any applicable fees or deposits, and requested power in a timely and informed manner. St Lucie County is not responsible for any delays in the receipt of electric power. We acknowledge and accept the terms of this permission. We further acknowledge that violation of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy of the site may result in immediate disconnection of this temporary power without warning and hereby release St Lucie County and all representatives of any and all liability resulting from us not abiding with this agreement. aoi-24' J��L 61 �� Print Name-Elect ' ontractor Company Name Sign, re- /contractor Date Sign ture-Owner Date Print Name-Electrical Contractor Print me-Owner ( 3yd- - 29i 3 (w ) 2�l rLZ�6 Phone Number-Electrical Contractor Phone Number-Owner a),5.��JS✓ License#Electrical Contractor Signature-Prime Contractor Date Print Name-Prime Contractor Company Name ( °In e d-7Z 5-'Y - 3 3 Print Name-Prime Contractor Phone Number-Prime Contractor 2q Z SC License#Prime Contractor Approved for St.Lucie County by: Signature-Electrical InspectorBO Insp ID# Date Inspector comments,limitations and restrictions: 2