HomeMy WebLinkAboutChange of contractor PLANNING&.,DEYELOPMEN'L SERVICES
BVILDINGf& ENING DiVY�IQN
' 11 VII�GINIAAVE,
FART)('IERGE,FL 34982":
(772) 462-M3 FAX.462 157$:
CUANGE:dF.CONT' ACTOR::4T)Tl;(`[)NTRA'C'Tni2:(172 [?AIT[`TT; =.A'i'TN nT+'a°Pi"e ilVi'fi
■...
P1;EA'SE'SEtttrONE 0Tt 1TI4E FOI.I bVItING:
CHANGE
OP-.-CONTRACTOR—ch goof Gontractoris to:be signed and notarized by tho property Omer"x
and_the nem contractor o. record fox the:eurrent'permit.A new'perm�t�ppl�catiori m s also a eorripleted wtth new
cQrit actor:inforn�ation,and signature-Anew Notice of Commencement must;be filed to the new;compactor's name
for,.job val`tes.;greater than $2600 ($7;500 if A/C Change=., * A::recorded- copy must be suGmitted,prior "to
com nencutg any work There a$SO,Qa fee,_for the Change°vf Gonfractor
CHANGE OF SUBCONTRACTOR—Subcontractor changes are tone completed bj�the general contractor;
The'new subcontractor-iriust.fill-out a Sulicontractor AgreementForm.'Thece-:s a.$5QO6 fee for the::Ghange af.Sa1=
Cogtractor
CCELIAT)<ON OF PERMIT The:canceJlatton of a permit is acceptabieonly t£no work has been done,
Cancehattoz of perinrt ts,to be signed,and notarized by'both.:tT1�owner and.qualifier,:ofr recoil There,.is no fee far
cancellation ttf the permit:
8t5J�Q
Date - r� ��„
Prermit:N`umber . ,.�a — S7
Site Address
PEAYS ELECTRIC Sta&License ER1. 0455 SLG, cenge<
OrIgmal GC,subcontractor orowner/btulder-
GOLD5TAR,,ELECT7NGState Ltcense EC130Q2082 SLC License.. r
New GC,subcontractor'
Reason forGancellation REAYS E4ECTRIG is no f - h lobs
onger,on t,ese
The understg ted does hereby agree,,olndemnify and Bold harmless StLucte.County,.iu officers,agents and employees from all;
costs;fees ordamages ansmg'from any and all clatmsof acttori for any`reason,;tivhtch may anseas a result of this change;af.
contractor/s ontractor cellatton'of,pOmrt,A permit cane t b'" a c lief>tf.wark ha5'been performed;
IGNTtfi8 tldec) iGA1A ERALQNTRACLOR(orncttGC asapphcablej,
PRINT 1'og BdaR W 138VIClSQ�;:,:
P"TNMAR I hnrCavnaf;
Stateof FJonda:Courity:of SLLuc�e County
`_M&ofTjdiida,Gounfy.of SE.:La id"c6iut}tx
Tlowrin ristnuriefit;was ac'66w-Wge&hefoieme this The fotlowmg instrument'rias acOm-mdedged;lieforc inc.this
5, dayafAUglAt .day of `;August 2Q by -
Q�..Y
'Brian W_Davtdstn .,
� ei5onall kiioimtQme John CaVF1aL
or� -
Si "store otiVotnry_ Date: 5tgoatge of 1Yotary Date
Revisedas , D11tAPNO y
PARR
.r« CDMNt5S10liIkGG `
:rg
r NY COMMISSJDN>rGGQ35Eq� it �'� piptcUbde+�+�*n
A IXPIRt=SEe �f ttwN�t
€e �e� �,� bNary,2Tr202te rp r;4+ &�+do`d _
_.. .... �Nolarl�CcUgdeiwilien' ,
PLANNW 'DEVE�'OPMENT
& S RYICES'
a
CIO ng & 0qO vsion:
' A � BIJILDIN�-PERMIT
-,�_.- ..._. ____ _. __..._-- •� SU-B CONTRACTORAGItEEMENT`
Gbldsia have agreed ta.tie
(Company Name/Indi-W@ Name),.:
Electrical: Sub coritractbr for': DA Hortorilr c
(Type tif"Tfade) mar'Gontrac or,,
,Forttiepro��ectnloc�tedat -• __.�._.__ mow(. , ., ,: ;; •�f�%'
(ProjedfStreet Address or,'Pioparty Tax ID#}
It is lznderstoq 34 that,if there is any change of status regarding our participat>on with the above mentianeci
project the Bullti>ng and Code'Aegulatkon Division,of St Lucie County wilfb actvlsed;pursuant.to the
€fling of a hapge of s-ub contractor notice.
C
4 _
GONTRAGTOR SIGNA SURE(Qgalifor
SUS. .. PAC. GNATUIR$.-(Qualifer)'
Brian-I Davidst n_
kRINT7\A11tE _ •,P.,RINT•..NAME... __. __ __"...._ _..`. __ _ _._ --_----.
CRC1327�68_ -ECI3OQ2082
Ct?UN I1;.CERTIFICATION;MJIYIB RCOUNTY.CERTITICA-TI014:NUMBER "
$tate of.E[or�da;;County of reVard 5fate of Florida,Coouty o4 ill aid.
Th!foregoing insfrnmentwass�gned-before me.this ` day o[ The foregom initr,`nment was-sf'ued•het$re'mefi isda of,
S y
Awusi% by Brian W Davidson �Aueusi r .:ZO 2d,bx of ri Cavnar --
-.._
who k-personalty knusn=X;or fiasnroduCed:a,.. T- ._, whois persouallylmown *-or'has'produceda.
tt
Sigaatitre`of.NotaryEubhc p Signature of.°NotaryP.,u6Lc
5 n; S '
Dtna 1'arrmo —y; Duca Pamno c
,qme;;4.., otary,.-o__!e -
Revised I;1/16201$