HomeMy WebLinkAboutChange of Contractor --�----- PLt�TNIIv�8�DE'VELOPMENT SE�.VICES ,
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230.Q VIRGINLA NEI
FORS PIERCE, FL-_4982
462:1$53 "X 462 1578:
CHANGE>,OF.CONTRACTOIr.SLTI#CCIN,TRACTOR.OR AN F. ', TION OF P.,ERNI`i`'.
T'LEASE 11 T 0",ROF`THE FOLLOWING:
CHANGEOF CONTRACTOR Change bfContractor is to$e signed and r�otarizeci by the'property ov�ner.
and`the new contractor ofecordfor the currentpermit.A11evY pe7incut'applica_tion;must also be cozrigleted vttr new
coritractor,information and;signature A tiew Not>ce of Cominencemenf mustbe filed:in the new`contractor's._ham
for fob values greater than $23500 57 500 if A/C Change.out} A recorded copy must, be sulimiftted prior ll
commencing any work Thereas a$50.O fee for the Change of Contractor
_X CHANGE:OF;MCO�NTRACTOR—Subcontractor changes are to Ue coinpletecl:<by the��eiieraCcor�iractax,
The -ractor--must fill,out a;Subcontractor Agre-emenf;Form:.Thereis a$50:,00 fee for the Cha rge of Sub--..
Contractor.;
CANCELLATION OF;PEIZMIT The cancellation-of a permit is acceptAble.od' f no work hasrbeen done,
Caricellahoi of permit j be-signed:and nataciied bX 64t1i tlie-owner and qualifier of r`ecor`d:There is ao fee.for
cancellatioin of"the permit;
Date
'8/5 0, PermitNumber.:
. CUa
Site Address
PEAYS EEECTRIC State-License ER120455? ' SLG'I✓i;cense __ --
_ ,,_ _
Original GC,subcontractor or omer/bzildcr -
GOLDSTARELECT INC
State License EC1UQ2082 SLGLicense,:..
New GC,subcontractor.'
Reason forCancellatiott PEAYSL'ECTRIC Is;no tongeron these jobs.: ,. -, _ ______
The:undersigned dogs:here6y`agree to indemnify and,lold harmless St Lucie County,its officersagents and employeas'frotii al
costs,fees,of;damages arising from any and all'clatms_of actt4n for any:reasori;which niay anse'as a result of this change of
contractors` ontractor aiicellafion ofg_e`rimfi A permit:can t;li' a e ed if work has been performed:,
g ::.
WPM w, i_. .._ ilder) IGNAT. CONTRAGIQR(ornewGC,.asap.P.hrable)-
PAINT NArIla grla "W D2VIdSCi(T PRINTNAKg, John'Cavnar', -_
State of Florida;County of St Luctounty""' Stute,of Flonda,Cptittry oSE;LucjeCougty:
The foiiowmg;instninicut--.vas ackin'awletlged'befozeihe tl ik.. Thbt!6N ns instnunent,.,s a&d&o edged:before_ a tfiis..
5 da of ..,August 20 20 fi'
`�+ dagofAUgust X022 bX Y. Y ._
Brian W.:Davi- wh is crsoiiail knownJohn:Cavnar
or who ha _ - me of ced
�..
S� nutureofNota ,Daf� S� atnr�of ota = Data
Revised ? _ rpt plNl4.> Ng3py
L OINAppRR1N0., 2 F3YCONtdiSSlt)pti£ 2p2i
:� AIYCOMMiSStON+�GG935S43 �.,`Z f7� �,ypt�GCU�t^�'
�e to r -ARES�'OlMWry27102�, Bo
' .,6a�dodfiruNofa+xPt�blai i, iwilhrs';`
i
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PLAN10 & DE'YEIOPMENT SPRVICE .
Build»g& 1c de.Comphance D>Eq s><on
B[IIL)IN PERMIT`
=CON TRACTOR A:GREE�
Goldstar-:Electric Ince have agreed'to be,
;(Company Name/Indtv�dua!Name}' - _
Electrical' __ _ _. Sub contractor for D.R..46 tdnJno__
fhe . - —
N r ._ -
(TypehofTrade)` (Pr`.mary Contractor)
For the`project.I,dcated -
(Pro�ect.Street:Address orProperty
lf,is,lundersiGod"thall if lherej&any,.change:of'sAdtus regardtng-our participation ori"th the<abave.mentioned
protect,,the,Building;and..CodeRegulmonInviS1QR.Of St.Lucie Coilnt will'6e ad riso -t t"
frling.of a Changeaof°Sub.=c.Qntractor not cea:
�Briari VV I?ayidson-_ ....__.. _.. _._. . _ __... John C'avnar'-
_._ ___. ____..... _.._ ...m ._.:._.:
PRINT IveltiiE� • PRINT NAAZE
.CRCI32706fi' _._ : EC13Q02082 ,-
-- -
COUNTI'CERTIFICATION'NU19B 12, COUNTY CERTIFICjgr NUMBER
State of Florida,Cquaty of ceyard Sate of Florida,County of BrCyard.
The,-.,,f6regoing instrument was sigaed.P*0 me lois 5 ';day of Tlie foregoing instrument was signed before me this s day of
kueust ,Z9 20,b3` `Brian W Davtdsbri Ausust zo_ZO 6� John Cavnar
who�s personally known `x,or prod! 'it who rs personally known X o ,has produceda.
I SJ too!t 2hon as gicohficatton X -
Signaturc.ofAotaEY,PubUc :.r SignaofN taryPublic, x
Dina Furmb ' ;z Dma Par o
rmL ame o Diarynat amao otary n e r .
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Revased f1%16/'�Ol'6