HomeMy WebLinkAboutCHANGE OF CONTRACOTRtf4r _-) /
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
C�IAL�LCEOF CONTRACTOR _
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
signature, and transfer fee. 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. Subcontractor changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 12.23.2021
Site Address: 8208 S Ocean Drive, Jensen Beach
Carney Electric
Original General Contractor (or Subcontractor)
Adams Electric
New General Contractor (or Subcontractor)
Reason for Change Not able to do the job
Permit Number: 2107-0092
State License EC 1301-2944
State License EC-1300696
SLC License
SLC License
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 contractor/subcontractor or cancellation of
permit. A permit cannot cancelled if work has been performed.
1 SIGNATURE OF OWNER (or o er/buu der) f* IGNATURE OF NEW GENERALL C NN�TR TOR
PRINT NAME -�� PRINT NAME ' /� N //
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following in ment was acknowledge a re a this
day of 20by__ ��
'11111,4t tL who is personally know to me
or who as produced as ID.
Signature of Notary Date
*Only signature required for change of
Revi
PRANCES DONZA
MY COMMISSION # HH 111471
EXPIRES: July 27, 2025
''•'.EoY��?"' Bonded Thru Notary Public Underwriters
The following inst ment was acknowledged before me)this
IeLday of 2J!7by_ 4zZa,
who is personally know to me
or who has produced IV as ID.
Signature of Notary ate
su
;�,,P�F •••. PRANCES DONZA
MY COMMISSION # HH 111471
rsPo: EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters
PERMIT # ISSUE DATE
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
(Prof ct Streetgpess or Property Tax ID #)
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 a Change of Sub -contractor notice.
CONTRACTOR SIGNA ualifiier)
P NT NAME
COUNTY CERTIFICATION N ER
State of Florida, County of
oregoing instrument was sign before me this ay pf
2 11
o is rsonally known _or has produced a
as identification.
STAMP
Signature
FRMur-o `11147A
MY COMMISSION 27 2025
EXPIRES July de��itors
public Un
gondedThruNotary ..�°'
Revised 11/16/2016
S ONTRACTdk SIGNATURE (Qualifier)
6
PRINT NAME
l'�l.��i�
COUNTY CERTIFICATION ^," CY�""
State of Florida, County of `7
foregoing instrument was si fore me
e p's day of
2
Vh. �persomilly
bygho known _or has produced a
as
Print Name of Notary Pu is
ti,•pY PU ••
FRANCES DONZA
MY COMMISSION # HH 111471
• ;:
EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters
STAMP
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL. 34982
Phone:(772)462-2172 Fax:(772)462.6443
Permit# SLC- 2107-0092
Issued: 9/20/2021
Job Location: 8208 S Ocean Dr
Jurisdiction: SAINT LUCIE COUNTY
Subdivision: DIAMOND SANDS PLAT 2
Flood: AE
Inspection Card
Permit # : 2107-0092
Online address:
hftp://www.stlucieco.org/planning/permiffing.htm
Quick Links:
Permit Status Lookup
Online Building Inspection System
Confirmation 902 Status ISS
Type: BUILDING RESIDENTIAL (SFR UP
TO 2 FLOORS)
City: Jensen Beach
Parcel: 3527-501-0032-000/8
Lot: 31 Block:
Elev: Flood Map: 303G
Set backs: Left: 8.50 Right: 8.50 Front: 20.00 Rear: 5.00
Job Description: New Single Residence 4.5 Bathrooms/ 4 Bedroom/ 2 Car Garage
Elev. Cert. / Flood Zone Info. On File
Occupancy Type: Residential R-3
Construction Type: Vb
Occupant Load: 8
Sprinklered: No
"All Supporting Paperwork Must Be On Site For Inspector"
Contractor Alan J Tarpell -- Cert # 29613 Ajt Construction Consulting Llc (561) 307-6262
1760 N Jog Rd Suite 120 West Palm Beach, FL 33411
SUB -PERMITS
Permit No Status Permit Type Cert # Owner/Builder
2107-0092-01 Issued ELECTRIC - RESIDENTIAL 29281 Carney Electric Inc
2107-0092-02 Issued MECHANICAL/HVAC RESID - FIRST 29147 Cmi Air Conditioning &
TIME INSTALLATION Electrical
2107-0092-03 Issued PLUMBING - RESIDENTIAL 0127 The Plumbing Company
The Treasure Coast Inc
2107-0092-04 Issued ROOF - FIBERGLASS SHINGLE 28578 Michael Kevin Walsh Roofing
Inc
2107-0092-05 Issued GAS/GAS PIPING - 1 & 2 FAMILY 27064 Martin County Propane
RESIDENTIAL
For the automated inspection system call (866) 284-1280. To schedule an inspection online go to
http://codeinspectionpublic.stiucieco.gov. All inspections requested prior to 9:00 PM will be scheduled for the next business
day. Inspection requests between 9:00 PM Friday and 9:00 PM Monday will be scheduled for the following Tuesday. If you
require any assistance please contact the Building Department at (772) 462-2172.
Report prepared on 9/20/2021 7:07:55 AM