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Home My WebLink AboutWS Lot 47 - Change of ContractorPLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 4624553 FAX 4624578 �43*" 4. r 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 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 cancellation oflIthe permit. Date: (1Plao,acQ4 Permit Number: 5e3,Dl�'t�1vU5 Site Address:,, �wM �—�x — State License SLC License Original G , subcontractor J Qf)b�TM M D J C 4 � i i IM12:t► O State LicenscCACNffl_7 SLC License New GC, subcontractSr Reason for Cancellation Non -Performance The undersigned does hereby agree to indemnify and hold harmless S cbsts, fees or da ages any and all claims of action fora contractor/s co or or cancel ation of permit. A permit canno h SIGNATU OFO ar owner/builder) SIG PRINT NAME Kevin Borkenhagen PRINT Slate of Florida, County of St Lucie County The following instmment wasppack�anfowledged before me this d who is personally knownta r has produced aslD. Signature otNota <',`.•'•"•""�'k•: )DA-EEN F.INGERSOLL Commission # GG 149183 ='�,F,`oas` Expires November3,2021 .' Bonded Thru Troy Fain lasuranrn8 Revised 04/15 agents and employees fror as a result of this change of m Jeffrey C, Lindstrom Slate of Florida, County of 5t. Lucie County The follmving instrument wds acknowledged before me this x� day of .um 20 x�by u.emGrma.uom wh ersonall e�isr to me or ohaspr uced as ID, Tll,_�t -�- �Q�212 t Sig nature of Notary Date l't°� �Ik�AGIBBS �'°�: MY COMMISSIONI%GG 198705 .co; EXPIRES: AFtil22, 2022 goFi�4•° BondedThru Nolory Public Undaiwrilers All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` h e I G Date: (0 a��\ Permit Number: 5� aol o `I�� P °�D4 AY Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential xxxxx 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 4624553 Fax: (772) 4624578 PERMITAPPLICATIQN FOR: Chan Address: Property Tax ID #: 1711 ^ lam- Site Plan Name: Waterston Phase One Project Name: AspireAt Waterstona Changa of Contractor- Non compliance of Contractor - HVAC New Electrical Meter Second Electrical Additio I workto be performed under this permit —check all that apply: echanical _ Gas Tank _ Gas Piping _ Shutters _Electric _Plumbing _Sprinklers Total.Sq. Ft of Construction: Cost of Construction: $ �— ANI M _Generator Lot No.W_ Block No. OJ _Windows/Doors _Pond of First Floor: _Roof Pitch Utilities: _Sewer _Septic Building Height: )•' � "s� Sd:�?'1F vr'�pr�fi� Sf�'� E�R/ , S,��E��v.��t`-'i�� ".e�', ��;a� .YMu:• �-nw,-^�,r trn,�} �� Y i �'GO,.,[�,�T�R CTO�R.,�.�- i'b• t' `�'�r�° t� Name VWbXL Name: Jeffrey C. Lindstrom Address: Company: Lindstrom Air Conditioning & Plumbing Zip Code: 24o Fax: Phone No. 0,110t — gi�s Staten'"d Address:4290 SW Port Way City: Palm City State: Fit Zip Code; 33490 Fax: Phone No954-312-2963 131 ' E-Mail:�llLit-4W ®K 1,1c,�r60" Fill In fee simple Title Holder on next page from the Owner listed above) ( if different E-Mail lisag@lindstromair.com State or County License CAC056971 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: _ Not Applicable MORTGAGE COMPANY: Not Applicable 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: 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. Lucle Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure 'applicable which Is in con ict with anyHome 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 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 Commenc ent may result in paying twice for improvements to your property. A Notice of Commenceme m st be ecorded in the public records of St. Lucie County an d o e jobsite before the first ins ection If yo i d to obtain financing, consult with lender o n att be re commencing work or r ordin o N is of Commencement. Signature of Ow essee/Contractor as Agent for Owner Sign ure� n ctor/License Holder STATE OF FLORIDA LO STATE F A COLINTYOFK� pn COON OF uiDQ� SwSm to (or affirmed) and subscribed before me of Swo o (or affirmed) and subscribed before me of V Physical Ergwce or. Online Notarization Physical Pres or. Online Notarization this day of 2Q9 by this Z4 day of I JOE 202# by K,„,a,4uin Borkenhagen Name of person making statement. Name of person making stat nt. Personally Known _ e OR Produced Identification Personally Known OR Produced Identification T e of Identification Type of Identification Pro ced Produced (Signature of Notary Pu Ic;„ptaze o C �J (Si ny ature of Notary Public , + �'•- ;;. .INGERSOLL 4•.....oh,.,; LISAGIBBS mmi on GG149183';.' Commission Not e� M ISSIOPIfrGG19818 Commission No. -u: - �� .110 vYoc„ Aires oe ber332021 to ffff Bonded Thm Troy Fainlnsurance800.385701 F.G: April 22,2022 rL •�''°pC Sc`a�`BaIMod Thru Y,ur��y r+upli6Undorwdl rs REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.