HomeMy WebLinkAbout2105-0711_Kelly_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 PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
X 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.
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: 8/9/2021 Permit Number: 2105-0711
Site Address:
Alliance Group State License CCC1330918 SLC License
Original GC, subcontractor or owner/builder
Radford Construction LLC
New GC, subcontractor
tate License CGC1522578 SLC License
Reason for Cancellation Too many legal problems for original contractor
.. ly�Me
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 y rise as a ult of this change of
contracC7�
or or c at' n of permit. A permit Cann be can ell if or as bee p rformed.
SIGNATURE OF OWNER (or own 'builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAME Christopher A Ke ly PRINTNAME Erick M Radford
State of Florida, County of St. Lucie County
The following instrument was acknowledged beforeme this
10 �of k5 � ' 20 71 byC Kr r � kc
i who is personally known to me
or ho has roduced D - �e-j L�" as ID.
i4,8/9/2021
Signature of :Votary Date
State of Florida, County of St. Lucie County
The following instrument s acknowledged before me this
76daayy� S 20g/, by ZC / L
Fc_,Vok who i persot nallyyk.to
me or who has produced as ID.
Signature of Notary Date
TERESA INCHIERCHIERE
Notary Public - State of Florida
Commissior C GG 324404
or My Comrr. ExS,,es Apr 30, 2023
Bonded through National Notary Assn,
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —s—'4 Permit Number:
P L c R� c c, Ct Building Per Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 10830 Kimberfyld Lane Port Saint Lucie FL 34986
Property Tax ID #: 332150100210006 Lot No. 21
Site Plan Name: Block No.
Project Name: New Roof
I DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING CEDAR SHAKE ROOF REINFORCE TRUSSES PER ENGINEER DRAWING INSTALL 30# FELT
AND POLYGLASS TU PLUS TILE UNDERLAYMENT INSTALL 24-GAUGE METAL FLASHINGS AND INSTALL 13"
FI AT CONCRETE ROOF TII F4 WITH MARA RQQE III F AnHFSIVE a.Fgr) _';Q FT All 9P
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers _ Generator x Roof 6/12 Pitch
Total Sq. Ft of Construction: 4,596 Sq. Ft. of First Floor:
Cost of Construction: $ 140-000-00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Christopher Kelly
Name: Erick Radford
Company: Radford Construction LLC
Address: 10830 Kimberfyld Lane
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No.
Address: 4285 SW Martin Hwy. Suite #108
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone No 772-260-9491
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail radfordconstructionllc13@gmail.com
State or County License CGC1522578
11 Vdlue oT construciion Is c5uu or more, a KELUKDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Luci County and sted on he jobsite before the first inspection. If you intend to obtain financing, consult
lencleii or a attorne fore commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF h�vdo'112,1J
Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization
this _/(�_ day of J :S 20 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
( ignature of Notary Public- State of Florida )
s
llu �,/ or• TERESA INCHIERCHIERE
Commission No' 3 `) /Y (Seal) _ • r Notary Public - State of Florida
`IK Commission 9 GG 329404
'F n• rti My Comm. Expires Apr 30, 2023
Bonded through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5120121
11 PERMIT # I2105-0711 I ISSUE DATE 16/11/2021
PLANNING & DEVELOPMENT SERVVICES
`' J - ~ - Building & Code Compliance Division
•
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Cisco's Roofing & Repairs
(Company Name.'lndividual Name)
the Roof
(Type of Trade)
have agreed to be
Sub -contractor for Radford Construction LLC
(Primary Contractor)
For the project located at 10830 Kimberfyld Lane Port st. Lucie, Florida 34986
(Project Street Address or Property Tax ID ts)
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 hange of S ntract notice.
CONTR_WTOR SIG:NAT RE (Qualifier)
Erick Radford
PRINT NAME
State# CGC1522578
COUNTY CERTIFICATION NUMBER
!' State of Florida, County of // &r ,%
The foregoing instrument was signed before me this% day of
20d by /'/ ✓ C/-� —' �T �t.rf
who is personally known /or has produced a
as identitic ion.
STAMP
Signature of Notary Public
P mt ame of.Nota�blic
=°f•� y.•:.
TER -$A INCHIERCHIERE
Notary Public - State of Florida
01 `
Commission
Revised 11116,2016
rlu
M� Apr 30 2023
3orce
c thr 4.gh rational Notary Assn.
SUB T ualifier)
J ery Cisco
PRINT NAME
State# CCC1327871
COUNTY CERTIFICATION NUMBER
State of Florida, County of 'S+•L(Kt-e—
The foregoing instrument was signed before me this l 1 day of
UC
4 XS ZOZ1.by latC�
eho is personally knowrkK or has produced a
s identification.
CJI/�_&\STAMP
Signature of Notary Public
Print Name of Notary Public
mowy Putft Sfale d Florida
a y� � N5 110731