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Home My WebLink AboutWS Lot 18 - Change of ContractorPLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 4624553 FAX 4624578 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 of the permit, Date: V1er1�� Site Address• ��"1 �`p Permit Num. ber:�� pmYW� U �4,1L 1,0�6 .4� 060 State License SLC License 'Original G , subcontractor k owner/builder L QJ)bJ) f20M N IG4 —YLl lWW! KJ& State LicensdCAOZ 7Z 1 SLC License New GC, subcontract r Reason for Cancellation Non-Pertormance The undersigned does hereby agree to indemnify and hold harmless S costs, fees or da ages � ixgfre»l any and all claims of action fora contractor/sq cot or or cancellation of permit. A permit canno h SIGNATU OFO or owner/builder) SIG PRINT NAME Kevin Borkenhagen PRINT State of Florida, County of St. Lucie County �T�hle follogw;Iing instmment wasgacknowledged before me this K ['.V'�11 �ab�' by - produced as lD. Slgnamrc otNota :'"�;:, ��{�1-EEN P.INGERSOLL Commission # GG 149183 ' =s'"• Exp(resNovember3,2021 'fh'`'`, Bonded Thru Troy Fain insurances Revised 09/7.5 agents and employees frog as a result of this change of $NTRACTOR (or new CC, es applicable) C. Lindstrom Slate of Florida, County of 5t. Lucie County The following instmment was acknowledged before me this z! day of +� 20 z.:1,by x±yc.uwwm w9t ersonell ;z% to me or o has pr need as ID. IL�t �� rQ,2�rJ21 Signature of Notary Date �0 ,11i LISAGIBBS COMMISSION': GG 108105 . oa EXPIRES: AP1i122, 2022 Bonded Thal Nalety PubtleUndeWdiem All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11 AA —1 Date: W e'1L�% Permit Number�l i Q1 Q1 - � 1 O4QVWWD LMQ�I 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 PERMIT APPLICATION FOR: Change of Contractor - HVAC Address: Property Tax ID #:1"Sl1 - 10..V ' (1l bd Site Plan Name: Waterston Phase One PYoJectName: Aspire AtWaterstone Change of Contractor- Non compliance New Electrical Meter Second Electrical Additi al workto be performed under this permit —check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Electric _Plumbing _Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ �_ _ Generator. _Windows/Doorsmi Sq. Ft. of First Floor: Lot No. Block No. 3 _Pond Pitch Utilities: _Sewer _Septic BuildingHeight: �at p �r �i? &.4u-�tf�a.nrr.�3a1j � x ` a � CO R A '�an...�45 'a,}St s�� f-• TOR :�Jb ��e. �'.�� ,i, "*" .e >..,_ � - � Name 'J"%1[1 Name: Jeffrey C. Lindstrom Address: Company: Lindstrom Air Conditioning & Plumbing Cit �o.�2'90h State QIq Zip Code: 5406 Fax: Phone No, lad t ala546. Address:4290 SW Port Way City: Palm City State: Fl Zip Code: 33490 Fax: Phone No954-312-2963 E-Mail:00Y.11 ,OPJ &6WW 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 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 TITLE HOLDER: _ 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. 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 Assocration 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, wails, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of CommencpSient may result in paying twice for improvements to your property. A Notice of Commencers m st be yecorded in the public records of St. Lucie County anjpn d o1 a jobsite before the first ins ection If yo/i ipkapd to obtain financing, consult for Owner STATE OF FLORIDA COUNTY OF w�a�•�.a� Sworn to (or affirmed) and subscribed before me of Swop P sical P�'ce or Online Notarization ✓ I this day&AAAAW 20J4 by this 2 K,� aouin Borkenhagen Name of person making statement. Name Personally Known •� OR Produced Identification ivoe of Identification (Signature of Notary P Ilc�take o��)r �NGERSGLL P 9�mmi�so0GG 149183 Commission No. �fpues o ber3,2021 Bonded TW Troy Faln lnsummi FRONT (or affirmed) and subscribed before me of :ical Pres or Online Notarization day of I1►�_ 2021 by making Personally Known '� OR Produced Identification Type of Identification of Notary No. -- LI8AGI005 M 0 18S:Otl t. GG 798 rs;nr:nzz,zozz Bm�dod Thm nutruv NOW unary REVIEWS S MANGROVE REV EWLE I I I I ZONING I S R I I VREV COUNTER REVIEW REVIEW EWON