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Home My WebLink AboutWS Lot 10 - Change of ContractorPLANNING & 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 PEIRMT 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 commencing any work. There is a $50.00 fee for the Change of Contractor. xxx 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 cancellationof the permit. /I Date: (,PJ�IaCQi Permit Number: _ 'CRISS Site Address: �Q � �•t�e.. �.ax► State License SLC License Original G , subcontractor ir owner/builder UuoSyl�om NJC4�hinamo State Licens D5 SLC License New GC, subcontractSr Reason for Cancellation Non -Performance The undersigned does hereby agree to indemnify and hold hartnles: costs, fees or da ages any and all claims of action for contract or/s cot or or cancellation of permit. A permit cannnt{I SIGNATU OFO or owner/builder) —SIGI PRINT NAME Kevin Borkenhagen PR State of Florida, County of St. Lucie County The following inslmment was acknowledged before me Ihis J .tlgyppAgllgA„h cn ,by n has produced as to, Signature of NetsP `'�'ti•: �A-EEN FJNGERSOLL Commission # GG 149183 "'Ex ires November3,2021 t°Q'� Sonded Thairmyrain lnsurenreg Revised 04/15 County, its o��tt''Icers, agents and employees from all n, whicj�ma7/�arise as a result ofthis change of t4NTRACTOR (or newCC, as C. Llndsfrom Slate of Florida, County of St. Lucie County The following inslmment was acknowledged before me this z� day of �m Zp z�by �mn c.ummm� wh rersonall own to me or ro has uced,�_as IDoI� I— Sig nature) of Notary Date �`�I��AGIBBS pAyRl4"9:�': � MY COMMISSION # GG 108105 ;o'? EXPIRES:APlil22, 2022 "'•'•?;o;p�g• BandedThnr Notary Public Undetwnlere All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED W Date: a!k 2C0-% Permit Number: SW� aMe 'C75973 0 Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential xxxxx 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 4624578 PERMIT APPLICATION FOR:C Address: Property TaxiDq:_)'5.11— 1L1 Site Plan Name: Waterstone Phase One Project Name: Aspire At Waterston Change of Contractor- Non compliance e %J Contractor - HVAC New Electrical Meter Second Electrical Meter Additional workto be performed under this permit —check all that apply: 3EMechanical _ Gas Tank _ Gas Piping _ Shutters _Electric _Plumbing _Sprinklers Total Sq, Ft of Construction: Cost of Construction: $' _Generator Sq. Ft. of First Floor: Lot No. Block No. 3 _Windows/Doors _Pond _Roof Pitch Utilities: _Sewer _Septic Building Height: ,i,i T `fR � O:�R Name '*J Name: Jeffrey C. Lindstrom Address: Company: Lindstrom Air Conditioning & Plumbing City. mil_ Zip Code: 06 Fax: Phone No, Vol "5 State L51 Address:4290 SW Port Way City: Palm City State: FI— Zip Code: 33490 Fax: Phone No 954-312-2963 v E-Mail: �1l1Gi6AL30 ®K-.� . 010" Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail lisag@lindstromair.com State or County License CAC066971 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. DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address; Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: Name: Not Applicable 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. certify that no work or installation has commenced prior to the Issuance of a permit. St. Lucie Count makes no representation that is granting a �ermit will authorize the permit holder to build the subject structure which Is in con ict with any applicable Home Owners Assoc ation 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 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 Con improvements to your property. A Notice of Commence Lucie County anc� d or ejobsite before the first i with lender o nr n atto vv before commencing work or .SI as Agent for Owner STATE OF FLORIDA STATE COUNTY OF w��«�•�• COUN' Sw to (or affirmed) and subscribed before me of sicP ceor_Online;4byzation this dayof 2 �,. j"Vin Borkenhagen Name of person making statement. Personally Known •� OR Produced Identification Tune of Identification may result in paying twice for be yyecorded in the public records of St. vop imftd to obtain financing, consult Swo o (or affirmed) and subscribed before me of Physical Pres or Online Notarization this 4 day of IJ►� _ 2020 by �eSim (1, LIB 1� Name of person making sta=ORPro t. Personally Known ✓duced Identification Type of Identification Produced (Signature of Notary P Iic;,.Staxe o�'i��l)F INGERSOLL 7 (Signature of Notary Public � uSAGI6Bs mmi a GG 149183 °•- MYSCO ISSlOPI ikGG t98 Commission No. . } e� Commission No. l �31A xpxes o e her 3, 2021 P.' rz F,S:Apr1122,2022 REVIEWS SREVIEW R VREVIEWON SREV MREVIEWVE I COUNTER I ROEVIEW I I REV W I I EWLE I