HomeMy WebLinkAboutChange of Contractor (Permit 2012-0631)- PLANNING & DEVELOPMENT SERVICES
11 BUILDING & ZONING DIVISION
COUNTY 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERNIT
PLEASE SELECT ONE OF THE FOLLOW I, N '
_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: 9/21/2021
Site Address' 151 Ocean Estates Dr, Ft Piece, FL 34949
TRM Construction Managment Inc. State
Original GC, subcontractor or owner/builder
PB Built State
New GC, subcontractor
Reason for Cancellation Owner decision to change contractors
Permit Number: 2012-0631
License CGC 024829 SLC License
License CGC 026712 SLC License
The undersigned does hereby agree to indemnify and hold harmless St Lucie
costs, fees or damages arising from any and all claims of action for any as
contractor/subcontractor or cancellation of permit. A permit eai a ca
SIGN R (orowner/builder) -I GRATURE GI
PRINT 56�7f PRINT NAME_
O ua f, r;:. t_ I-t- L
State of Florida County of St. Lucie County State of Florida, County of St. Lucie County
its officers, agents and employees fror
ch may arise as a result of this change of
if work has been performed.
CONTRACTOR (or new GC, as applicable)
Anthony Panebianco
The following instrument was acknowledged before me this The followin i s mt was acknowledged before me this
Z k day ot�j , 20 Z tt , by :YL M!e ZCday o 20U b
tjG�tlna+— who i nor mown o m who is personally known to
or who has produced as ID. me r as produced as ID.
QA,t,� �rr►wM t �TB/21 /2021 /21 /2021
Signature of Notary Dale Sig ature of Notary Date
LORI ANNE DEMARCO
';Notary Public -State of Florida 16
Revised o9 � ++; Commission If GG 908503 ;: Y'Pr�•. JENNIFER DAVERSA
My Commission Expires':°.�` Nota Public State of Florida
August 28, 2023 a i a• "�iCommission d HH 05635'
ye,
My Comm. Expires Oct 22, 2024
I 3onded through National Notary Assn.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
{ 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 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 151 Ocean Estates Dr, Ft Piece, FL 34949
Property Tax ID #: 1403-500-0036-000-6
Site Plan Name: Avalon Beach P.U.D.
Project Name: Avalon Beach - Lot 20
DETAILED DESCRIPTION OF WORK:
Construction of a new single family residence with driveway, fence and patio deck
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
X
Lot No. 20
Block No. 2
Additional work to be performed under this permit— check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors _ Pond
x Electric x Plumbing x Sprinklers _ Generator x Roof Pitch
Total Sq. Ft of Construction: 3,401 Sq. Ft. of First Floor:
Cost of Construction: $ 427,109.00 Utilities: x Sewer _ Septic Building Height: 30'3"
OWNER/LESSEE:
CONTRACTOR:
Name Ocean Estate Drive, LLC
Name: Anthony Panebianco
Address: 9508 Windy Ridge Drive
Company: PB Built
City: Windermere State: FL
Zip Code: 34786 Fax:
Phone No. 772-546-4197 E-
Address: 2151 S. Alternate A1A, Suite 425
City: Jupiter State: FL
Zip Code: 33477 Fax:
Phone No 561-575-0664
Mail:-Matt@gelcorp.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Alyssa@pb-built.com
State or County License CGC 026712
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Nasrallah Architectural
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 3920 Edgewater Drive, Suite 101
Address:
City: State:
Zip: Phone:
City: Orlando State: FL
Zip: 32804 Phone 407-647-0938
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 Count nd posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with IWlerr an attorney before commencing work or recording your Notice of Commencement.
�J/�_
Signa of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF �},. I�u C % e
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this 'Z N day of 20EL by
nnaV-),QA\Cc)
Name of person making st tement.
Personally Known OR Produced Identification
Type of Identificatio roduced
(Signature of Notary u lic- State o lorida
ENNIFER DAVERSACommission
Public • state of Floridamission
No. (Seal) # HH 05635tm.
2024ugh
trl:!=
Expires Oct 22,
National Notary Assn.
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