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HomeMy WebLinkAboutUpdated application- 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: CHANGE OF CONTRACTOR --- Change of Contractor is to be signed and notarized by the property owner, a d the new contractor of record for the current pen -nit, A new pen -nit 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: February 16, 2022 Permit Number: 2202-0090 Site Address' 11850 APPALOOSA CT, PORT ST LUCIE, FL 34987 COMO Oil and Propane Original GC, subcontractor or ownertbuilder Ferrellgas New GC, subcontractor State License SLC License State License LGO1237 SLC License 31370 Reason for Cancellation N/A- DOING A CHANGE OF CONTRACTOR ONLY 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 a d all claims of action for any reason, which may aril as a result of this change of contracto /subcontract or cancel ton f permit. A permit cannot bf cancelled if work ha been performed. SIGNAT RE OF O//I���rNERpp(,or��ownerlb�uiilldjer) ^ ,,,,� SIGNATURE GENERAL CONTRACTOR (or �n'eww GC, as applicable) PRINT NAME 1lt tCa_L,A ` j,/t(,tJ UC0 PRINT NAME .1 Urn State aI'Florida, County of St. Lucie County The rollowing instrument was acknowledged before the this day of�, 202Z by� who is personally known to me or who has produced as ID. `�--� February 16, 2022 SignatureoNotary Date Revised 04/15/1 0' Notary Public State of Florida i+ Cathy L Gaspar My Commission GG 367185 V ; Expires 1210812023 Oi A State of Florida, County of m U,(+i n The allowing' the was acknowledged before the this Tdayby ' �)T) ITGr who is personally known to rpe 4 who has produ d ti ' as ID. $SION •ys1 ��� • #M 174432 a �A onded % ir11�•• Q 9�p� Public Dade PE All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: s Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: LP GAS PROPOSED IMPROVEMENT LOCATION: Permit Number: Building Permit Application Commerdai Residential X Address: 11850 Appaloosa Ct, Port St Lucie, FL 34987 Property Tax ID i#; - - 16- 00-9 Lot No. 13 Site Plan Name: Michael Mirando Block No. A Project Name: DETAILED DESCRIPTION OF WORK: INSTALL 500 GAL UG LP TANK AND LINE FOR GENERATOR CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: Mechanical VGas Tank VGas Piping — Shutters Electric ^ Plumbing — Sprinklers Total Sq. Ft of Constructlon: Cost of Construction: $ 6272.55 _ Generator Sq. Ft. of First Floor: — Windows/Doors Roof Pitch Utilities: —Sewer _ 5eptic Building Height: OWNER/LESSEE: CONTRACTOR: Name Michael Mirando Name: TOM Fite Address: 11850 Apgaloosa Ct Company: Ferrellclas City: Port St Lucie state: FL. Address:- 3232 SE Dixie Hwy City: Stuart State: FL Zip Code: 34987 Fax: Phone No. 772-979-1858 zip Code: 34997 Fax: 772-287-3456 E-Mail: mmmirando23@gmail.com Phone No 772-287-4330 E-Mail KimWllkl ns@ferrellgas.com_ _ Fill in fee simple Title Holder on next page ( If different from the Owner listed above) state or County License 31370 If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required. 1f value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required. DESIGNER/ENGINEER, Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone 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 insta€lation as indicated, certify that no work or installation has commenced prior to the issuance of a permit. St, Lucie Count 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 fo€€owing building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE"EFORE RECORDING YOUR NOTICE OF COMMEACEMENT." 1' Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Il aT#11 LxA_c,,o COUNTY OF Martin I rfrpl� The forming instr ent was acknowledged before me this its dayof 2D Eby The fo oing instru w this day of y X0ti�1111 jackno \ %fie NA,� OM •' :�2 ���i `� '7 s Tom Fite ,.a�,e�Rz$�`�N•. �1C�a� (yL,� • �� s Name of person making statement. Name of person making statemE)W Personally Known OR Produced Identification Personally Known V �• #HH 174432 ; OR Intificat€on I?ded Type of Identification Type of Identification �i� lJn �'•.���*� Produced PrGduced .,. ••'Fcn'��� Auk _19ignature ot Notary Public- State of lorida j (' Nota ublic- State of Florida ) Commission Na. --&7 7l votary Public 5 �`� teer Fl°ris Sion o. r (Seal) Cathy L Gasp My Comm'ssian G 357185 23 Of REVIEWS FRONT ZON NS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev, 2/7/7.9 MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 4996935 OR BOOK 4776 PAGE 787, Recorded 02/18/2022 04:26:23 PM NOTICE OF COMMENCEMENT TO EE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS 62,500.00 OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS $7,500.00 Permit Rl da09 -OnAo Tax Who O: 3309-605-0016-000-9 Slate mirarida, Ccuntyof The Undersigned hereby gives notice that Improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following Inform Ilan Is provided In this Notice of Commencement. 1. Legal description of the pro"at"'a"I ampfete street addr 's available): Pony Pines -Unit One 81k A of 13 (1.84 AC) (OR 885.8 : 181 M 62) 2. General description of im rov ment: Install underground YtanPi and line 3(DOwner information or ©Lessee Information (Ifthe Lessee contractedfor the Imp(ovement): a. Name: Michael Mirando b. Address: 11850 Appaloosa Ct Port St Lucie, FL 34967 (street address) (complete city name) (state) (rip code) c, Interest in property: OWNER d, Name & complete address of fee simple titleholder (if different from Owner listed above): 4. Contractor: a. Name: FERRELLGAS b. Address: 3232 SE DIXIE HWY, STUART, FL 34997 (street address) (complete city name) (state) (rip code) c. Phone number: S. Surety Company(ifapplicable, a copy of the payment bondis attached): a. Name & complete street address: b. Phone number: Bond amount: 6, Lender/Mortgage Company: a. Name& complete street address: Is. lender's phone number: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by Section 713.13(1)(a)7., Florida Statutes: a. Name& complete street address: b. Phone number: Fax number: 8. In addition to himself or herself, a. Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. b. Phone number: 9. Expiration date of notice of commencement: (the expiration date will be 1 year from the date of recording unless a different date Is specified). WARNINGTOOWNER: ANYPAYMENTS MADE BYTHE OWNERAFTERTHE EXPIRATIONOFTHE NOTICE OFCOMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER713, PART I,SecTION711�t3 j, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FO ROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THERE PIRH��.IPYOUINTe�AIN FI CIN.CONSULT WITH YOUR LENDER ORAN ATTORNEY BEFORE COMMENCING WORK qR RECORDING YOUR NOTICE OF COMMENCEMENT. ItIlliiiff�� �/ X (pW, "-N (Slgnatme of Owner of Lessee, Or Owners al lessee's Avthorl7ed Of�Eer/Olretto..((r/��PJartner/M��an��ag��er) (Signatory's Tftle/Offlrel The foregoing instrument was acknowledged before me this -Al.!! day of. /�('.41!'[,CW7 _, 20Nd' By:(printednameofpersonslgningabovel t „-C.^On�g Q CV�✓JG�W Y�Z%(�Jr As: Q(Qt.9 For (type ofouthaAtNe.g, officer, trustee, ottorneyinfary (name ofparty on belralfol whom Instrument was executed) ersonaliy Known OR O Produced Identification Type of Identification Produced �l Notary Seal NoterySignaturk tary [ey l ' r�Na hcSa le of Flontla thyL GaMyCoolon GG 3671R5 a9G10B20 p223Notary Printed me n Doug Kelp Fe Account Manager rP +ram ff�rsl'ga�yM�/i 772 216.2650 cell 772 267-3456 fax AitylP(n�(ar I(as OD 1i us omer ID 234918593 Mike Mlrando Date; 2/8/2022 - Revised 02-09-2022 11850 Appaloosa CI Purchase 500 UG LP Gas Tank Pod St Lucia. FL 34987 I trL^ d 2�a ail � Phone 772.979.1856 To Install: Sale and Installation of 500 gallon underground LP tank and gas line to generator. Proposal is subject to site check and must meet all state and local codes 500 Gallon Propane Tank $ 5,100.00 sell UG Installation $ 1,350.00 'Anshorsysmmaadanods Lrtluded Ext. Line up to 10' of gas piping 11yp�t JJ�a]. ��•• $ 450.00 'Mlmmen, of$450,0a.ddloan.I par root 0 $ 12.50 InI Line up to DD'of gas piping fU i"I lD �'�,_"• l��'j°l11 •Minimum or 5650 gg@aaubnalp rl t� $16.50 First Fat@ San. plan Ai to be bflledaeperadely faxes not I al rded. Final Connect and 1 cutlets Regulators Sub Total Tax Permit TOTAL Tasks... It.., A she aervay h d.posd Sn $ 225,00 $ 340.00 $ 5,465.00 Safety&hank end$(an Up Advisers, SI' l-oe Valved, clear., old. 7,00% $ 382.55 425.00 u.ppnFanl. 6,272.65 r for perelli ing purposes. There 1s a Miremum d-&weeks period needed for parmlt processing (from the ride the I) snorts agyµork being performed an slit' • SaAriwe mada awshonllllog wlllraatdlean.ddakgel W W90d far prore4erng& bee will be ad4ilhnol oe,,es, PoRrolleaa b sot s.,co Wble for damage W on burns or Ross gnello ing erdgnd9M1 olostri., ate.) not marked by conlral balling eaMao. Honfeowner 4 maponelbls la ..,it their .wn spine, or low velloge lines • P@vellges k col reepan9lbe. for placem .1phyeicel adluelre.re of apple..... • FedelfPs or not responsible for 4alnago to of replacement of landecapog, cononso sandals or any alaotdoal. Cusb nor is responsible for prwidleg boor and conversion wit to eonven any gas opplikeoao tar ode at propene. • penamtars do meutmd to hev.m flexible line to oonnaot lags.. • ddslamor'e credll most be approved pilot to aommendanent of ally work. • Anyd.eving, dkelflonei baring, exl000lya I.[., a, lel rodµ vrdl reouim an deal b.Ma. ` aoudlrg of Ilne.le be done by others, Undargruvnd look. In,ted.e ethodIs prclaollon. A 60%deposit Is due upon ed totenoe. A 10%crnoellalbn ponally will apply, Pla.se df etfyou have read Is egret to the fdegeing proposed oerred&recast It "The undersigned agues thel In the event that It becomes necaBa oUil le any ntllt ten $ dredlilons atlhm rorkNol Ihelihe undelpsik shall b separable In @roill,as LP for any& all attorney tees anaor tests lneul by Fdfrdlgea ale ng to the .,for and of the eossl., ° % Customer Signatures Date: C/'\ d - Fedellgas Valid to, 00 gays Contact Information Penny Randall Kim Wilkins Jane Conner Dale: Administraflve Pennfeupllaas vO r Penalt(intr k)nwdR'n5 rfli (tam011nBs.co/n School &MconrrorlwlarLeOnas.com 3232 SE Dixie Highway, Stuart FL 34997