HomeMy WebLinkAboutChange of ContractorCOUNTY
F' iL FO R •I D A - AJ
•
•
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DMS1011
_ RECEIVED
2300 VIRGINIA AVE
FORT. PIERCE, FL 34982 MAR 2 510(21 '
(772) 462-1553 FAX 462-1578 ST. Lucie County, Permitting
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
R
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
'-' T-1- CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: march 25 2020 Permit Number: 2001-0090
Site Address: 18601 Tranquility base lane
Steve Castonguay roofing
State License SLC License
Original GC, subcontractor or owner/builder
Cardinal roofing and siding co inc State License
New GC, subcontractor
Reason for Cancellation Change of contractor
SLC License 9072
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from aX and all claims of action for any reason, which may arise a a result of this change of
contractor/subcontractor or cnceln of permit. A permit cannot be cancelled if worlyj�asen performed.
SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAME�f�Vft .�� %rG17t'�SGc� PRINTNAME ��� D If� tAeg1.J
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this ire following instrument was acknowledged before me this
a.b day of V-Q'r 20�! ,byV^',1 �day ofVNO%r 20214 ,by %^\J%qo I
\) %�- Y w V� Ci S a who is personally known to me D \ f I -kr-. q s h a who is personally known to
Or who has produced L- as ID.
\1� march 25 2020
Signature of tary Date
VFv _ DEMNA MARE GIVEI !S ( ?
Re. 21' f5/1N�y cow4iSSIoiq 9 GG U?20'_3 t
:a = EXPIRES: December 16, 202U I i�
••,,poi F��•` Bonded 1'hru Notary Public undenvrilers �f�
me or who has pradns '� 0 t^ as ID.
march 25 2020
Signature of Notary Date
SL y • •
PERMIT # ISSUE DATE
CC)UNTY:,�
t -
PLANNING & DEVELOPMENT SERVICES _
Building.�i: Code Compliance Division P CEIVED
BUILDING PERMIT
SUB-CONTRACTO R.AGRE EiNI ENT
MAR 2 5
ST. Lucie County, Permitting
0 0 / i'l CO. 10 C ' have agreed to be
(Compan ame/Individual Name
the _ ?�rl J Sub -contractor for bi n c' Co rt�'7ft CJ7
(Type of Tr e) (Primary Contractor)
For the project located at ! 126c) ) 'rr& 4 tr IT f
(Project Street Address or Propert Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -co tractor notice..
O
COMrRUCrOR SIGNATURE (Qualifier) SUB -CONTRACTOR SiGNATUR ualifier)
m r�►�;L 17t�
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida. County of _ We %
The foregoing instrument was signal before me this day of
who is personally known _or has produced a- J-%- D L—
as identification.
Signature of Notary'Public
Print Name of Notary Public
a
0E4NNA?,1AfZIEGIVENS
'*i A* MY COMMISSION N GG 0?20.2.3 !
oor EXPIRES: Decamb2r i6, 2020 i
fYa�{rj„I f /16BZ y� Thin Ptota
ry Fublic undei'm110!-
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PRINT NAIiE
COUNTY CERTIFICATION NUIVIBER pp
State of Florida, County of�O-C,
The foregoing instrument was signed before me of
MAI r�lh -, 20 Rod S 4-4 n
who is personally known �ot has produced a
as identific tion.
STAMP I STAMP
Signature of Notary Public
J�Cnn �' ►� �� trls
Print Name of Notary Public'
JENNIFER DAVIS
MY COMMISSION # GG 953418
, po ` EXPIRES: February 29, 2024
''fP�fl °• ` Bottded'Rw Notary POW Unt►etttm'tem