HomeMy WebLinkAboutChange of Contractor MANNIN &, EMENT$VMWES
AT DING* DS.GD SH N
2300 VIRINIA AVE
FO12T PIERCE,FIS 34982
(772} 462-1553 FAX 462 1578
CHANGExOF CONTRACTOR S MC'ONT`RAC'TnR t)R'f'ANCELLATIOlrT OF!PE ;MT
PLE-Ak ALECT:ONE 6#THE FOLLdyhNG:
_ CHANGE OF CONTRACTOR Change of C.ohtracfbr isll ta' a signed and notarized by theproperEy owner;
and`the ne"w.contractor of record for the:current:,perinit .A new permit,applica�ton riiust aisa:be.coznpleted" vitl new:
contractor information and;;,signature A new Notice of.,Commencement must:be filed in 'the new icontractoev name
for job values greater than $2;500 ($7;500 if A/C Cwge-aut) "A.:recorded gopy mush,be s htiiitted`prior tri,,
coirirrienctng an- W--- There is'a_$50;00 fee,for the Change,o Contractor;
XCHANGE OF SIIBCONTRACTOR Subcontractor changes'are to lie completed by the general contractor:
Tlie new subcontractor must fill out a Subcontractor Agreement Form There;is a$50 60 fee"for the'(;hange of Sub-
Cont>tacto�-� _.
CA CELLATION OF PERMIT The cancellation of a permit is acceptable only ifno woek has been done: .
_
Cancellatio7 of permit is,to'be:signed:'and notarize-&- Moth the ownerY d":qualifier-of record° There Js•i10 afee f'ar
cancellation of theQermtt '.
Date s>srzo Perm>If lumber CCT
c3 c3
7
� 'N�ruyr�f'L
S>ite;Addl�ess� �� '' r _
_ .
PEARS ELECTRIC,. - _ r. __ ..... . Mate License ER'[2045
SLGLcense-.,. _ ,
MigtnaL'GC,,-snticontrac`tor or owner/liOder
GOLDSTAR ELECT(NC State-�icense.EC1300202,-_ -__ SLC-License:-.-
New GC,,subconti actor
PEAYS ELECTRI "ia"no4ongeron hese obs.
Reason for Cncehaton.� __...
The'understgned does:hereby agree to=indemnify and hold hatmtess StT_.�c�e County;;ts officers,agents,;and employees-from alL
costs,'fees,ordamages artsingyfrz.om any and alG clatms?of action for anyfreason,whtcli may arise as arrdstilt of th§change-,of
contractor/s" ntractor; ancellation- ermit .A:permit can t a ed E'work h is been performed; .
:
ERAL;CQNjRA TOR(or_neu.GCy asaPPhcabie)=
PRINT NAME.Brfan Vl/ Davidson' rRINT3IAME ..-.Johm avnar:: -.,. _:.. -
Stat�of Florida;"Countyof SLLuc�e G°opnty Sfate;of&londa,Copnty o€Sf._LucicCountp `
The:folIotivmg[ttstrumenf was aclmow3edged beforeme this TI*follow g►dst untent Gvas aclmowle ed before ineihis
5' daY4ff ttgUst;^ 201 �—'ay.. - _
Brfan W.D;avrdson.
tivhoas ersonatlykngwntome., ,lOhn_,CavnBf
or wha ha,�,te H�; me or ced
S�ggature of?Tota I?ate Stgoature of Ngtary " Dater
Revised f —"� �,r*t DINAPARtZ193 '�
DlwtpARRiN0 t= S►oNff
CObNiS_-
a: -.i..MYCOMMf9S[ONk'GG.9356g3. •, Q(p�tE8�Fe6toae12un?dtt�n'
s
?° t7ot�sY
:� �P EXPIRES tehnrary27�102{F '.te tq`6pndbdl�
x _
PERMIT#` ISSUE DA7M /
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W37. ,� :PLS, NG &.bEVELOPMENTl ERVICE i
Building &...Code C3,'ompLance MY,
4
BUILDING PERWT
SUB-CONTRACTOR AGRSEMM-,
66fifstark--fedi,inc -.... have agreed to lie!
(ComganyFlVametlndtvift!Name;
fW- , --Efecfricai for I3.R.Hortot "Inc
T e of Trade _
yp } (Primary,Contractor
i
. k
Forthe proJect;'iocated
_r
(Project S.treeC;Ad&ess_nr Property
It Is understopd h-" if there is any°change of status regard>ng=our particYpation with the-.above smentonecl
pro�ect,;the Buxldingand Code Regulation Dlvis oxl of St Luere CountX*H dvis
be aed pursuant, the
fiImg of a Change gf`Sub-contl•actor notice:
CONTRACrOR:SI_NAT.0 - ( ua. fiery SUB RAC NA,tuRF{(QuaL6er)- __-
$Hati'W,Daw,son. _.J;ohn Caynar-. ..
PRINT'N,0lE PRWr,,MMO.
_,CRCI3Z7QG8-:.,_ EC13Qa}2Q82
�=m:-
GOUNT ESRTIFICATIO'i W i BER; G0-iP1TX=CERTIFICj1 TI01N NUMBER -
State ofRlor�da;Co uty of Brevard. Suie of Florf Ta;Cougfy of'BreVard.
T& regoing instrument-was.;signed;before me.ttiis�_ :day of. The foregoing thstrnment.wAs sigge�'6efore mettiis i; day of
— August ,zo_20 uy:_ _.Brian W-Davidson Aueusf... ,;20 0.'by; Jolin'Cavnar•
w6o;is'personally knownx;,or has produced a — wfio�s personolly known x gr lras,prpduceda
kidenhfication as"identdicahon
sig,nature ofNotargPublic' u 5ignstare of NOtaryPubiic R
Dlna Parrino' c� `_ s Dma Parnno;
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'Rewsed ll(t6/20I'6