HomeMy WebLinkAboutChange of Contractor °, PLANNING&;DE '00MMTS
SERVICES
, COUNTY
BIIYLDING.� �UNIIY+f�I MS10
2300 VIRGiNI AVE
FORT PYER( X%-3
Y _:f (772) 462-1553 TAS 4b2 1578
MANGEQF ON'F ACTOR,SIMCUr('I'R G4TOR OR C NCFLLATIDN O PFRivlrTt
PLEASE`SETEt":.'T'O1VE OR T•HE FOLL.QWI1tiTG:
CHANGE OF CONTRACTOR Change of Contractor is to'be signed and iatarized by the propertyownet`;.
and the new contractor of ecord for the purr: t`pe-I ft.t nem permit'App It must alsa;'be completed"4vxth,rierr
contractor.:"
inforinafion,.arzd stgtiature„A;;new l�lottce Qi"C:ommencement mustlie filed ln:tlie-neiu.eontractor's :name:
for job values greater than $2,500 (V. x504 if A/C Change:out) A recorded copy must be submitted prtbr'tt
conimencicig any wor).T6erevas a_S50w00^fee for.:the change of Contractor
X GRANDE QF WWONTRAG:TOR—Su6rontractd't:cha69es,are to-be coriipkud�by the general`_contractor:
The iiew subcontractor inust'f i rout a Subcontiactor.Agreement-,Foril There is a$54 OO:fee for ttie="Change of Slil
Contractor.1 . -
CANCELLATION OF PERMI ` The cancellatton ofa permif Is acceptable only i£'no work has Been done
CancelIariori of pertnit is to'be signedf grid notarized liyboth the owner and'gual�fier:of.record•Tteie Vis:no'fee,.for-
cancellation of b.4 permit,
Date 8/510 :PermitNumber.
SrteAcidreask .�aZ`1,_ C?_ _0,11?rY C.._. :.
PEAYS ELECTRIC gFi 2? 55`.
State License SI✓GL'icense._ _.
Qrigmal GG,subcontractor
erl
GOLDSTARELECTING _$tateLicenseE.C13002082 SLC License _
New GC,stlicontractoi' ,
Reason for Cancellation PEAYS ELECTRIC is no,longof on these lobs.
The understgited does hereby-agree to,indemnify and fiold harmless St Lucie Copp-y'-is affcecs agents and empIoyees:>from alj<
costs,fees or:damages anstng from any and:$11 clatmsof action for any;reason,which may arise as a result of this change_of
con aetor/s` anttactor ancellatign of germit A permrf can t ba w�ed if wo lr has 6eetr performer,
S� tl er
NA_,. FI2AG CQNTR4CI'QR{or new GC_,,asagpl>ecafile).
glz=iu� rrBnan;.VN Davidson, pRINTNANtE. Jafin,Cavnarw -
State_dQlondkC!C yofStJL eCouniy; Stataof;Flonda;,GounkyafSt LucteCounty
TFib£oliowmg'instnunent was acl iioWledged:$eforemethis The w6wmg mstrumentwas aclmowledgedbefoie:me:tfii§..
5 AU`USt 5 dayday of •Ast;ugu .. -
Bdan w;:liotdsori
whals katiwtJOhnCVac v kn6wfiti6
or wlo hme or cS I
retlGt� ed `
Signature ofl?ratncy Date signature of Notary pate;
Revised
,R OIIVAPARR1pp :� }��:'�tYCOMNtSSiON
AIYc061MlSSJON>t'll --; g3 Ni gtpIRES fehsu�N�7 n
Ski SM A�
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FXPIf2ESiEeDNary2T,.2014: `f°,•.•• eaeedT�w .
6ondod nwflSlatYPifiCotlgdemlten
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' , „ ; .PLANNING & DE�ZOPMENT-SERVICES` � -
,4 BuTidng & Oade=Compliance COUNTY
Division
# BUILDING P #*T _
--------- SUB-CONTRACTOR AGREEIVIEN'T
Goldstar.tied tric Tnc-__-.-. .. .._. "
have agrecl to tie
- (CazFipany Nane/Indivival Naive)
the Electrical - - -- S.0tt`b d6 dt- "for'j -r D4R°Horton Iric
T e of:Trade rtm
{ ary Contractor)
R2
For the�prolect lodated of WIZ
TOt'nC�:. �...
ro'ect.Street,Address:orFro a TWD-##
Itis understood that,1 there is any?change of status regarding out parttciparion wit 1the above lrientionecl
pro�ecti,_the Bullding:and Code RegulatiWDty sign o£St Lucie Cau ty _ 1.`be-Ad-1,Nsed ursuant•_to the
filing of a Change of'Sub .contractor notice.
:C.ONTRA f Rbi NA RA GNATURE'(Quxiifier)
:,:Brian W Davidson
PRINtNANME PRINT'Nr111IE
,CRG1327U68 _:.: EC13Q:020$2:•:.
_.
COUNTVCERTIFIC'ATION>NUNMER. COUNTYCERTIFICAT.IONNUMBER- -- -=
SGtie of Florida,County df Brevard' State ofFtorida,County of Brevard::;
The foregoing in'str ument was'scgned_Gefore itie'tfits $` day ofThe foregoing mstrumentwas signed before methi9.�day'of
August 20 ZO 6y: Brian WDavidson -August zo 20 by___ JohnCavnar ....
whatspersonaIIyknown x'orhis iicoduceda w6oupersonallyknovvn X' o'r;baspro$aceda -
as identtficahon. - as identi6canon _
Signature ofhotary Public - "'" SigBature of NotaryPubLc - _ _._ =Z
Dula Pampa $ A�y z Dina P.amno
'.rint aIaCO 1 Ot81y :.0 C, Otalcy Pli, IC. -
Revised irl'it6/ZQ(Ei' - .