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Home My WebLink AboutCHANGE OF CONTRACTORSCANNED BY 3t. Lucie coy,* Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 Fax 462-1578 CHANGE OF CONTRACTOR__ Or u con ractor or .Cancellallien-a ermit 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: J4 e1OA/, Site Address: 0 d o ez" l,/ rr D Permit Number: 724 1 LC State License CaC 0R1580 SLC License Original General Contractor (or Subcontractor) Ale C#•NST1W c47, V Atc, State Licens G' aX � SLC License New General Contractor (or Subcontractor) Reason for Change T UN cc S ,s 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 be cancelled if work has been performed. SIGNATURE OF OWNER (or owner/builder) * SI OF NEW GENERAL C PRINT NAME !Col�P✓� Q• rprJ�e PRINT AMEN iti Aeel!�f 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 La day of k��t 20 by ' day of 20� by JJ1 r✓ who is ersona ly ]n to me who is ersonally Imo to me or rho has produced as ID. or�jho has produced AL--; ID. ��titte4�1' 1 �' �lo� l�O L(✓�vrtc / �1' Signature of Notary Signature of Notary ANNA MARIE GREEN ANNA MARIE.GREEN s Commission # FF 112005 ; , . , �*' *Only signatur 'q*ir€s MU3hl1T4A0 of: ubcont•ractor ` .: Commission#FF112005 •.',�aj�,' B�Tr. TmyFain Du�8063ES101D a "Expires August 11, 2018 B.WJWU Tmy FWn lnannoe 800J85.7019 Revised 07/21/14 � " `1111111111f SUPPLEME TAL iW10 STIMN LfEN LAW INFORMATI® 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 your paying twice for II improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite li before the first inspection. If you intend to obtain financing, consult with, lender or an attorney before commencing work odrecording your Notice of Commencement. iI, �illl ne Lessee/Contractor as ent for Owner Signatu:0F nature Contractor/Licens Ider ! If S TE RIDA STAT OF. FLORID C Sk L \)v- NTYOF The forgoing instrument was acknowledged before me this \ day of � 'C-��-- 20by The forgoing instr nt was acknowledged before me this � day of V� , 20 S by 5d\F\v.1C-k,� (Name of person ackno ledging) (Name of person ack owledging ) (Signature of Notary Public- State of Florida) (Signature of Notaryublic- State of Florida ) Personally Known OR Produced Ide 'rf rc%, as Type of Identifi ation �EpNNF Sk ° 10�6 - Personally Known OR Produced Identification Type of Identification Produced L IDL- e�b��C .\teg'0eC 8151 1 m EXp # EE aS �a�Y P � PUB" Commission No..El ; ,';M1• °m a��°na1N° u Produced ti ib I- pEANNA'G1�1 eNo FlOtida Commission No. -��o b1i�Se�2016 Pu ec Jr _ 1 _ unhNo1ary )� - . o, a-Ihto ites � , o . mm• Exp 856761 fission # lacy Assn. REVIEWS FRONT `ZONING SUPERVISOR PLANS VEGETATION" � MANGROVE COUNTER REVIEW REVIEW REVIEW- REVIE REVIEW- REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2014 JOSEPH E. SMITH, CLERK OF THE rTRCUIT COURT — SAINT LUCIE COUNTY FIDE # 4159151 OR BOOK 3836 .GE 160, Recorded 02/11/2016 L1:59 AM AFTER REWRDINO-PUMM TO: ! — PERMIT NUMBER: L .. I4_H u:e,E,>;+s'.edit,r. NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida statutes the following information is vrovided in the Notice of commencement; 1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER 131.2 ' l ` 001 — Coo- v SUBDIVLMION BLOCK TRACT LOT BLDG UNIT 22 3iv 31 4a4pRk o_ kT 1 L10r1 SEC 22 M pn - -ERaT PAR 6 F SE �� o f sE� ZI 2. GENERAL DESCRIPTION OF EWPROVEMENT: a'•tk Add.' , DA IOW=_ WO TION: c. interest in property d. Name and address of fee simple titleholder (if other than owner) 4. CONTRACTOR'S NAME, ADDRESS AND PHONE /N�UMBER: l X S,?lo _�. ll.A'j,Ji^ fni" , Sii�Tf /ZZ_ i 5. SURETY'S NAME, ADDRESS AND 6. LENDER'S NAME, ADDRESS AND NUMBER AND BOND AMOUNT: NUMBER 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1)(a) 7., Florida Statutes: NAME, ADDRESS AND PHONE NUMBER: 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section 713,13 (1)(b), Florida Statutes; NAME, ADDRESS AND PHONE NUMBER: 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) , 20 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AEM THE EXPIRATION OF THE NOTICE OF QOMMENCIa4IIVT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713 PART I SECTION 713 13 FLORIDA STATUM AND CAN RESULT ,_� Signature of Owner or Print Name and Provide Signatory's Title/Office `E2 Owner's Authorized Officer/Director/Partner/Manager Z o f— State of Florida County of _ 0, L,4 e v Q -2 The foregoing instrument was acknowledged before me this 2 day of _ J Amyltw,v , 20 l la �� x � Uj By Labe✓k A.1 ifl'e as 0myn 0 r-' C31 (Name of person) (Type of authority ... e.g. Owner, officer, trustee, attorney in facts I_ o CIO,1 nn I r 3 CID J For T ✓rAaAY}✓rl Ki (+r,G �nG. ru ¢ Q (Name of party on behad f whom instrument was executed) Personally Known '' z or roduced the following type of IDC�?� ANNA MANE GREEN r a .i 1•= Conuttlasion N FF ii2005 Avinn M. 6v<irt 1&4 /L "Augustii,2016 (Printed Name of Notary Public) (Signature of Notary Public)r:;,,,?, eawarrwmyvr.rrrnN Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and belief (section 92.525, Florida Statutes). 5104H 65) 9f 01Fill=l(5) 9I' OW—H r AY A09Iai1wh9 5=?d MOT@i By: BY Rev. oa/tMW(P.Wm ino 0