HomeMy WebLinkAboutChange of Contractor FIJANI�IING&tiTTEVELOPIV FNITT SERVICE
BUILDING &�'�ONING DIVIST�l�I .'
COUNT
23x0 VIRGINIA AVE,
PIERCE,
772 462',1553 SAX 46 157$
CHANGE'OFCONTRACTOR SLTRCONTRAC`TOR,,OR"CAkNCEL fATIUNOFPEi2NiT
PL,EASE-SELECTONE OF'T aFOLLOWING:
CHANGE OF CONTRACTOR—Change.ofContractoris to be-sigried and;rioti rizeii by.the=grope ty owner
and the new contractor of record for the current.perrnit Anew permit appltcahon must also be completed with new,
contractor�nfortnat�on and signature A riew Nntice of,Cort}mence�nent must be filed;to the:new, contxactor's nage
commncing any�work'There s��$50.06 fee.�for tfi Changtj f Contti�aetorrppQrded copy must; be submi>ted;pnor: to'
X CIiANGE'OF SUBCONTRAC' 9,—;S,4 bcontractor.changes Aare to be completed by the.general contractor-.
Tlie.new subcontractor must fill._out a Subcontractor Agreement-Form. The
re is $
a' 50:00 fee:for the>:Change t5f t yli-
Cantracioie. _
C. ANCELLA'I�ON OF PERMIT an
The.ccellation`of:a permit is acceptable only if work has been'dane.
Cancellatcort of'perim 19.1to be signed and notari
PERMIT# ISSUE2DATE i
�3
v. t
FLANl�TIN & DEVELOPMENT SERVICES:
Bvild ng &1c -C DMOQU
•
0 D � �BUILDIN.G PERIVIIT
— - eSUB-CONTRACTOR:AGI�EEMEYVT
GoIdstarTlectricInc.
;(Company NaineMdtv�d'ual Igraine)
e:of -rade
(Typ ) �Pt6ary;Contractor)
For the.prodect local ed at t wt3it
(Project.Street Address:or,Property Tax ID
It�s unrlerstool tihat if there.rst any change of:status:regardngour parttc�patpn�vttl the above mentioned
pro�ectrtlle Building=and Code Regulation Dtyis on,,- St_Lucre County wtll`:be ad sed.;pursuant to the
fP ng.of a Changeof Sub=contractor notice.
I_
SUB NAT[IRE(Quabfier�'; "
Brian W DA-vR&0n. .-.. ._: ,.._. Jolin.Cawnar... _ Y,..,m:...... - ._ .,.. .. . .,_ ....-.__.
_._.
PRINK'Nr!14�; PRINT-iVA`�1E"' .
CA 321069 EC13,002-082-„
COUNTY_CERTIFICATI011 1�'UMBER, COUNTY CERTIF1Cr1TION IY:UER
State of 13[onda,County of' 'ct yard''- Stste of Florida,Cuuniy ofBTeyard-
>he;foregoiugink rument was signed tiefore me;L>s—day of The foregoing mstrumentiaras s good before me this may,of
Aueust ,20 20''liq Briari.W David"son August'- ;oL_20'byr. T6fin,-avnar .
who is;Persooall ,•km wn X or has roduced a=— rido is,personaUylmown x.or-6as.produceda--.---
Q. P. _.
us-�dcnti6cationas idenhficxtroa
5ignatur ofNotary'Pab1k-: x t Siguature;of.•lYotaryPubue ,
.
DmaRarrmo z 1?�aa Parnno
r ,
;rant ameo ,otaT7 u �c o. rat amen otery" u} is o
Rewsed 11116120Th "�