The URL can be used to link to this page

Home My WebLink AboutChange of Contractor, to Owner builder, new application f' X � 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/ELECT 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. 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. I ' 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: "3('a� Permit Number: Site Address: i n S a. r`k0S cc!aD Ae,��'State License SLC License Original GC,subcontractor or owner/builder 1 •,. f State License SLC License ew GC,subcontractor i Reason for Cancellation 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 ,�nt bcontractor or c cellation of permit.A permit cannot be cancelled if work has been performed. YLSTGNATURE O ownedbuilder) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable) PRINT NAME�,��.��.,^ �� PRINTNAME 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 day of (� 1�/'11 .217 ,by�i�Lh l� day of 20_ by _'� i who is personally known to me who is personally known to or who has produced as ID. me or who has produced as ID. Signatur He Signature of Notary Date ,�"a'JPWUN" ELLEN VAUGHN s°�P G�`�SState of Florida-Notary Public j *= Commission # GG 270079 Revise MYCommission Expires - OeteueY 22 20r22 I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: V Lp'c� Ll ISM O - -= Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION. (OR: AI 21 afYrtla. 's.�i ~ 4 � V�r i4'f ZT .i R K _ #. - - - �,_ 7a7-.s-....-.,;L_rz.---OWN '�+.s.. a. :- T. �.., ..�� .,.. Address: 3� .�J�cJ,rCc��-kfn -P I _ � Property Tax ID#: �v t t� Pr'� D Q �9 Lot No. Site Plan Name: Block No. Project Name: zK at �� "g s gay :. �Q__ 20 n 9qe na,/GI, rt i„s ,d e a�-+� CJ c7}s��a dy,;L. a New Electrical Meter Second Electrical Meter (Affidavit required) Ij 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 _Roof Pitch Total Sq. Ft of Construction:' Sq. Ft. of First Floor: Cost of Construction: $ Utilities: -Sewer —Septic Building Height: a��m ��k��^��"�� •� a per_ � � ��3.� �'..yeye,��,'i �" __s'�Z�' °�' �� `- Name Rrc%�a�� .10 n�-.:� Name: Address: 3 /71' Company: 1� City: Zr'T Stater Address: 1 Zip Code: ��`�'�� Fax: City: State: Phone No. 7?a —v2 c'�1 4.4� Zip Code: Fax: I E-Mail: '7el (dI iilci�oo . Ca r''+ Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. I I 0-00� �,�. `� �+�: � .a � �;�_.. 4� �. � tee. .a � � �.,;.:. ..: .�� -�.�NOW 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. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. ��i�'e6� ignature of Owner/Lessee/Contractor as Agent for STATE OF FLORIDA COUNTY OF ��}UK CA . Sworr-Dto(or affirmed)and subscribed before me of _Physical Presence or Online Notarization this J1 day of OLU'k 20QA_by Name of person making statement. Personally Known OR Produced Identification Type of Identification Proodu1c'ed V L (Signature of Notary Public-State FI �B ELLEN VAUGHN YP�i ♦1pN i Commission No. _state of Florida-Notary Public Commission # GG 270079 4iF��g"; My,Commission Edfr�f�gPe� ires 2 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 512UIZI