HomeMy WebLinkAboutChange of Sub- contractor 8/25/2020 20200702_08351 Tipg
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B�ILDIN`Y &
'fl 1t -iRC=INIAAX'E
2300 N, i I9t32
t, .L i'1 1 L .�' E'�., F1, ` .
(772) 462-1553 FAX 462-1579
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PLEASE_SI;LEE;T ONE OF T111-F()1.1 OWING:
— -_- C11ANGE OF CONT12ACTOR- C' IALM
hattgrnzit. A t1c«contractor
applicatioulrnuslt also be co Tlci'ed 'IN""'`
le
and the nc w contractor of record for the current p rnu;t be
contractor information and sigtiatn}_ ALi l(] iftIce of A:'(' Chan, - ut)-mencomAt recorded to p}til 'ttrnust Ilse sctbr 1 ttccd [�rit>ri1t)
for job values greater than $2,500 (S.,-
conuiicnc:ing any work. Fbere is a$50.00 fee for the Change of E%ontractor,
X CHANGE 01f St:BC[)\Tlt�►E'"TOR -Subcontractor changes arc to be c+au�fslctcd by the Z�cncraf coati actor.
The new subcontractor must fill out a Subcontractor Agreement Forth- These is a �$t1.00 fee for the Change of Sub-
Contractor.
CANCkLLA1_1ON OFPm-,11-1- The cancellation of a permit is acceptable only if no work has he ctt c7nc.
Cancellation of pcntut is to be signed and notarized by both the o«ncr and qualifier of record_ There is no fee for
Cancellation of the permit.
06r2612020 Permit Number: __.2003-0704, -- -
Site Address: 328 Shady lane Port Saint Lucie, PI 34952 _-
Poorer Electrical State License EC13007325 SLC.License
Original GC, subcontractor or ownentbuilder —
E _
mil` �� -�-. State License tir�t s�:ti, ,� LC License
New GC,subcontractor
Reason for CancellationWant to be remove as electrical subcontractor. Having problem with owner.
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers, agents and employees front all
costs,fees or damages arising from any and all claims of action for any reason,yvh. r ma} i sc as a result of this change of
contractori'subcontractor or cancellation of permit.A permit cannot be ca ql it-work ltal$ been performed.
SIG 5 u (NAI[IC4 fvldf ,, sl iENERAL CONTRACTOR(or rmw--
(X:,as applicable)
PRINT .14A•1F, - W f� ._ � ) !¢V P1ZIA'"rNANIE_..
State of Florida Counry of St-Lucie(`ounr; State of Florida,C elinty of St.Lucie(`nunty
The following instrument was acknowledned before me this Is�hyye follor;ring instrument was acknowicdged before me this
Iz}of. Ul art 2€� D bv�D G.�i pG� [�(1v da��of �� fl b}.
�U�-�E/+h/ tah,�is persunall�I_nou•n tea me
Who is personally kn,%n to
or wilt)h:L nrcduc.d as 11) me or who has produced as ID.
44,,,,. 06/26,12020 0612612020
Signature of. otary Date Signature of Notary
Dace
RO&WARRIETA
MY COM1dMON I GG 35949
EItP S:Oe>i�r 19,2Q22 a°` `•P;ew� MARIE H.SAINT-GERMN
' �'^: Banded 1>•au T p I htc rs * * Commission 9 HH W8299
a„ of moires Jana 27,2024
y�QF FLaP\ HaYulid Thu dudgatt�LrySewfre�
https:llmail-google_corn/mail/ul0l#inbox?projector=1 1'1