Loading...
HomeMy WebLinkAboutChange of Contractor Planning & Development Services RECEI V zr D FEB 101 �- _ Building& Code Regulations Division T 0 Cie 2300 Virginia Ave. e - Fort Pierce,FL 34982 7 -1578 CHANGE OF CONTRACTOR Or Subcontractor or ancellation o it 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: !2 1/01 i (, Permit Number: Site Address: 250/ 0,epe- Pc,I`K 4o o- F4 • )0i,o rcQ � 1 C C O q S-'cls N 1_,L CG State License SLC License Original General Contractor(or Subcontractor) Q Ul i -ken f e.S i d Q/1-4-•i c.l cc r Q State License C RG/,'oIX�VSLC License New General Contractor`(or Subcontractor) Reason for Change Qu r1 _ 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, whi h may arise as a re ult of this change of contractor/subcontractor or cancellation of permit. er it canno nc d if work has been performed , SIGNATURE OF OWNER (or owner/builder) *SIGNATURE OF-NEW GENERAL CQNTRACTQ PRINT NAME �� U.� )�(j(�' PRINT NAME 1 11(O (� lUl l 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 acknow�Idge before m this /9 day of k,)) )a,1 4 20 1(,,bye) I(� day�(o�f 20�(,, UiC 1/cil,Q . � who is ersonally kno to me (��0(�1V L- who is sonally know o me o w orprvnced as Ip. or w 6I asp rc as ID _/ �1 cl Sig ture of Notary Date Signatu of Notary Date *fin v_sjwgna dgrg rezu'rimed for change of subcontractor JAMIE O'CONNOR N 'Poo, JAMIE 0 Cur+NUH Re Wb ft? 4%filic-State of Florida MW �, Notary Public - Stale ni fturida •_ Commission#FF 947403 Commission # FF 947403 ;soc My Comm.Expires Jan 3,2020 ; . My Comm.Expires Jan 3,2020 �O 1V Bonded through National Notary Assn. . �"'• Bonded through National Notary Assn. ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:��N\0i RECE14'LJ FEB 10 2916 Permit Number: I6d a-410 5 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial. Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: '7601 Q Q.Q_f- Qc f\k ao 9- Legal Description: La t-e.W©od (c - - sib J 8 - 6 L IL 4 0 1_4 'a(Z) Mae 13 IV � b c 38s t - lam Property Tax ID#: I SO 1 - 60 5 O O J�b -- 0 O©-- t7 Lot No. o� Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 14 i�&k( a. CONSTRUCTION INFORMATION: Additional workto e e orme under this permit-check a appy: HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors XlElectric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: i �Sef S . Ft.of First Floor: Cost of Construction: $ 6C'�o-a° Utilities:cnSewer 0Septic Building Height: is OWNER/LESSEE: CONTRACTOR: r Name U-C, Name: RJCAA ca C es'tJ&nAt,, C� Address: "7 ?41 1V- A4 i-1'C' �yL Company: P"C-�V\ Ge)i -q k !� City: \".) � 9c`�n State:�• Address: QJ-0 N W V-g l e J Q- DGS `� f Zip Code: 3-2.1+16 Fax: City: R S(✓ Stater Phone No. ),0 Zip Code: (p Fax: E-Mail: s L-e-U e- ' :D QU CCQ. CD M Phone No. 1 kph- 3 , ?� Fill in fee simple Title Holder on net 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. RECEITED FEB 10 20 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION; 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: 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 improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commen � , Work or-recording your Notice of Commencement. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLO DA. STATE OF FLORIDA COUNTY OF _,c.!(,t- 1)(I COUNTY OF �C The fgoing instrument was acknowledged before me The f oing instrument was acknowledged before me this day of 20 JLby this day of 20 by (Name of person acknowledging) (Na f person acknowledging) Y (Sigri ure of Notary Public-State of Florida) (Signat a of Notary Public-State of Florida) Personally Known V OR Produced Identification Personally Known \� OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. `� �(Segl) JAA1[ Commis on No. FE 4-7 ea ,`�'= Notary Puol c Stns , riunda A Pia,, JAMIE O'GONNO i•c Commission # Ff 9474p3 bre• �:� M Comm.Expires Jan 3,2020 - Commission FF gq� 3d: of Bonded i' Revised 07/15/2014 Bonded through National Notary Assn. Xv :� MF� Y Comm.Expires Jan 3 02( lo" Bonded Assr REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW DATE COMPLETE INITIALS _T !!IT# nCEI _D FEB 1 i'0 ISSUE ISSUE DATE I I PLANNING & DEVELOPMENT SERVICES Building& Code Compliance Division BUILDING PERMIT SUB-CONTRACTOR AGREEMENT St.Lucie County Contractor Certification Number: State of Florida Certification Number(if applicable): E-& i j o l 4-7o S A]n/( �; I-tI L / �� w� (�� have agreed to be the (Company Name/Individual Name) C / �e r--�n'r -, Sub-contractor for 9I`Lk co we i der, (Type of Trade) .. (Primary Contractor) For the project located at '7G0 weer Pari 4,1e , ,P-g-rc-e4 �2 (Project Street Address orProperty Tax ID#) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub-contractor notice. (Form: SLCCDV(No.004-00) BUSINESS QUALMER (Name of the Individual shown on the Contractor's License) r%.[OT h,CZE . z'.TUMES -f- iU I r`,_.P Business Name: w M c 71✓l Address: i pre5St'- (-n City/State/Zip: T fi , fterc g Sum 2 D, / Phone: -)I;?- email: _ L✓m�F�C Cc��ic�s� �.� G CURE PRINT NAME DATE STATE OF FLORIDA,COUNTY OF .c. w x J THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME TATS 1® DAY OF ,20 �!o BY- )I IU m �kA) WHO IS PERSONALLY KNOWN _OR HAS PRODUC AS IDENTIFICATION.. JAMIE 0 CUNIVURR SIGN DRE OF NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC = Notary Public-state of Florio & Commission#FF 947403 My COMm.Expires Jan 3,SLCPDS:08/06/2014 �o ded through National Notary2A? PlanninOADevelopmentServices ASBESTOS NOTICE Byllding;&Cotle Regulation'Division :3300 Virgfrh'Avenue; Fetf.Pierce;FL 34982; Phone(772j!62 2172 Fax(772)4624 Asbestos Notice to Contractor February 10, 2016 RICHCO RESIDENTIAL CORP RICHARD J GULASH F79 pLk � 2190 NW RESERVE PARK TRACE#3 F PORT ST LUCIE, FL 34986 RE: Building Permit Number 1602-0125 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. ignature ' /C) Date 2/10/2016 3:45:46 PM