T:\BLD\Bldg_Forms\New Applications\Applications\Change Of Contractor Application.Docx Rev. 9/21/11
MARTIN COUNTY BUILDING DEPARTMENT
900 SE RUHNKE STREET
STUART, FL 34994
(772) 288-5916
FAX (772) 288-5911
MARTIN COUNTY CHANGE OF CONTRACTOR APPLICATION PACKAGE
A document review will be performed on the following items prior to the submittal of a
permit application. Failure to submit these items will result in the application package
returned to the applicant until the deficient documents are included. This review sheet must
accompany the application submittal.
Please make sure you have ALL required copies before submitting permit application
You will need the following to change from one contractor to another (or to change from
contractor to owner/builder):
_____ 1 Copy letter from the owner releasing the old contractor and hiring the new contractor, or
cancelled contract.
_____ 1 Copy of application completed by new contractor.
_____ $20 Transfer Fee (if permit has already been issued)
_____ Notice of Commencement (if over $7,500.00 for A/C Change Out and $2,500.00 f or all
other permit types)
* If changing from a contractor to an owner/builder, the owner must supply the following:
_____ 1 Copy completed Owner/Builder Affidavit
T:\BLD\Bldg_Forms\New Applications\Applications\Building Permit Application.Docx Rev. 11/10/15
Martin County Building Department
900 SE Ruhnke Street
Stuart, FL 34994
Phone: (772) 288-5916
Fax: (772) 288-5911
BUILDING PERMIT APPLICATION
Residential □ Commercial
PROPOSED IMPROVEMENT LOCATION
OWNER INFORMATION OR LESSEE INFORMATION (if the Lessee contracted for the improvement):
CONSTRUCTION INFORMATION
PERMIT APPLICATION FOR:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Additional work to be done under this permit check all that apply:
Air Conditioning
Burglar Alarm
Fill
Gas Line
Gas Tank
Irrigation Sprinkler
Land Clearing
Low Voltage
Electric
Plumbing
Shutters
Windows
Impact
Resistant Glass
Provide all that apply:
Total Sq. Ft. for proposed structure under conditioned air: ______ Total Sq. Ft. for proposed structure: _______
Cost of Construction: $_________________ Utilities:
Sewer Septic Tank
Construction Type: IA____ IB____ IIA____ IIB____ IIIA____ IIIB____ IV ____ VA____ VB____
Bldg. Height ________ Bldg. Sprinkler:
Yes No Protected Unprotected
Address: ___________________________________________________________________________________
Property ID#: _______________________________________________________________________________
(Found on Tax Receipt or go to www.pa.martin.fl.usput cursor on “Real Property Search”, click “Address” follow directions)
Subdivision Name: __________________________________________________________________________
DETAILED DESCRIPTION OF WORK
CONTRACTOR’S INFORMATION:
Name: _________________________________________________________ Phone: ___________________
Mailing Address: ____________________________________________________________________________
City: ___________________________________________________ State: _________ Zip Code: __________
Email Address: ___________________________________________ Fax: ____________________________
Interest in property: (e.g. Owner, Lessee, Tenant)
Fill in name and address of fee simple title holder on the next page (if different from Owner listed above):
Name: ____________________________________ Company: _____________________________________
Mailing Address:
___________________________________ City: _____________________ State: ______
Zip Code: _________ Email Address: _______________________________ Phone: ____________________
Fax: __________________ Martin County or State License No.: ______________________________________
Contract Date: __________________ 10% Deposit Taken: Yes No Date Taken: ________________
Select from the drop-down list
T:\BLD\Bldg_Forms\New Applications\Applications\Building Permit Application.Docx Rev. 11/10/15
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engineer:
Not Applicable
Name ______________________________________
Mailing Address ______________________________
City ____________________________ State ______
Zip __________ Phone ________________________
Mortgage Company:
Not Applicable
Name ______________________________________
Mailing Address _____________________________
City ____________________________ State ______
Zip __________ Phone ________________________
Fee Simple Title Holder’s Name:
Not Applicable
Name ______________________________________
Mailing Address ______________________________
City ____________________________ State ______
Zip __________ Phone ________________________
Bonding Company:
Not Applicable
Name ______________________________________
Mailing Address _____________________________
City ____________________________ State ______
Zip __________ Phone ________________________
Notice to Owner: There are some properties that may have deed restrictions recorded upon them. These
restrictions may limit or prohibit the work applied for in your building permit. It may be to your
advantage t
o check and see if your property is encumbered by any restrictions.
Owner/Cont
ractor Affidavit: Application is hereby made to obtain a permit to do the work and installations as
indicated. I certify that no work or installation has commenced prior to the issuance of a permit.
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 Code 5th Edition (2014) and Martin County
Amendments. Plan revisions on all structures exempted by code from architect/engineer design may be done by
permit holder.
Warn
ing 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 attorney before
commencing work or recording your Notice of Commencement.
I c
ertify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
(FBC 5th Edition 2014)
____________________________________
Signature of Contractor/License Holder
STATE OF
FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this ______ day of ______________, 20___ by
__________________________________________
(Name of Person Acknowledging)
_____________________________________________
(Signature of Notary Public State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary
Public)
Personally Known ____ OR Produced Identification ____
Type of Identification Produced
________________________________________
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this ______ day of ______________, 20___ by
__________________________________________________
(Name of Person Acknowledging)
___
_______________________________________________
(Signature of Notary Public State of Florida)
(Prin
t, Type, or Stamp Commissioned Name of Notary Public)
Per
sonally Known _____ OR Produced Identification _______
Type of Identification Produced ________________________
________________________________________
Signature of Owner/Agent/Lessee
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this ______ day of ______________, 20___ by
___________________________________________________
(Name of Person Acknowledging)
___
________________________________________________
(Signature of Notary Public State of Florida)
(Pr
int, Type, or Stamp Commissioned Name of Notary Public)
Per
sonally Known _____ OR Produced Identification _______
Type of Identification Produced ______
___________________
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T:\BLD\Bldg_Forms\New Applications\Forms\Notice Of Commencement.Docx Rev. 9/15/11
NOTICE OF COMMENCEMENT
To be completed when construction value exceeds $2,500.00
PERMIT #: TAX FOLIO #
S
TATE OF FLORIDA COUNTY OF MARTIN
T
he undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida
Statutes, the following information is provided in this Notice of Commencement.
L
EGAL DESCRIPTION OF PROPERTY (AND STREET ADDRESS, IF AVAILABLE):
GENERAL DESCRIPTION OF IMPROVEMENT:
O
WNER INFORMATION OR LESSEE INFORMATION, IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name:
Address:
Interest in property:
Name and address of fee simple title holder (If different from Owner listed above):
CONTRACTOR’S NAME: Phone No.:
Address:
S
URETY COMPANY (If applicable, a copy of the payment bond is attached):
Name and address:
Phone No.: Bond amount:
LENDER’S NAME: Phone No.:
Address:
P
ersons 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: Phone No.:
Address:
In addition to himself or herself, owner designates of to
receive a copy of the Lienor’s Notice as provided in Section 713.13(1)(b), Florida Statues.
Phone number of person or entity designated by Owner:
E
xpiration date of Notice of Commencement:
(the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of
recording unless a different date is specified):
.
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES AND CAN 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 ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
U
nder penalty 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.
Signature of Owner or Lessee, or Owner’s or Lessee’s Authorized Officer/Director/Partner/Manager/Attorney-in-fact
Signatory’s Title/Office
The foregoing instrument was acknowledged before me this day of , 20
By: as for
Name of person Type of authority ;Ğ͘Ő͘ŽĨĨŝĐĞƌ͕ƚƌƵƐƚĞĞͿ Warty on behalf of whom instrument wasĞdžĞĐƵƚĞĚ
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Personally known or produced identification
Notary’s Signature Type of identification produced
(Print, Type, or Stamp Commissioned Name of Notary)
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signature
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