HomeMy WebLinkAboutChange of sub-contractorIdERNIMERMEEM
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
® 23O.0 VIRGIIVIA AVE
I I NOW, FORT PIERCE, FL 349.82
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASI's 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 Commeheetnent trust 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
coign ncing any work. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor mast fill out a Subcontractor Agreement Form. There is it $50.00 fee for the Change of Sub -
Contractor:
CANCELLATION OF PERWT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: cl, a • Permit Number:
Site Address: ` Io 41
c: su r-tt_lFi r r- F --u � t-, � '�c ; : t:�..�'� ctl fir. ✓".
O trigi i GC, subcontractor or owner/bUild
ti ;• " n i V "'k. f_' L� tr 1 �'_ i'Y) Y"� C._ State License trl t=1 43( l .3 SIX License
New Ct, subcontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and Bold harmless St Lucie County, its al'ficcrs, agents and employees from all
costs, fees or damages arising from any and all chrims ofaction for any reason; which Wray arise as a result of this change of
act fsubcontractor(or�cancellation of permit. rl permit cannot be cancelled iirk has been performed.
SIGNATnURt: OF OWE UR (or a�yrytaye�build(er^} SIC;NA"[IJRt' LIEN t-('ONTRA('T'OR (orne%v (iC, as applicable)
rRIiJ` ?11' i_7._`_r�_l'i� PittNTNA\lt.DdV1C2 PY10E --'-__-------
State of Florida. County or St. Lucie County
The following insirurncnt was acknowlkAgedbefor im this
_dar of \ 20
....._..-t
.__..._ ...-_.-. . _ _eho is personally k1lown to the
o %c oha, produced.-„_ _ _asII1).
Signature of Notary Date
Rom: s_c t` 4
ocsaY A�e� RHONDA$ ROWE.
Aa ������' Commission # GG 104656
1u� , r Expires May 19, 2021
1FOF��' ' Bonded7hruBudgetNotagServices
State of Florida, Count" of, st. Lucie Count;
Th • folknrinc rust anent w•a> ,in xlcdged + tiir�+nut is
o .-day of -_ �OCG, by t "---
who is lersonally knovtn to
me or crho as produceclas
[Dp.
Signature of \otaqD:ue.
aa.,p v r04p,c Notary Public State of Florida
KarlLJHBrtel
My Cssion GG 164365
oF oa Expi3012021
PERMIT ## ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
EUIIiDING PERMIT
SUB -CONTRACTOR AGREFIkIENT
Hypoluxo Plumbing, inc `- _ have agreed to be
(Company Name.Individuat Name) (Ze r\O
the. Plumbing _ _ Sub -contractor for Ritar Builders, Inc.
(Tyl)e of Trade) (Primar)., Contractor)
I J'` _ S f� Y f
For the �ru trc:t located at
(Proicet Street Addre. s o Prn erly Tax ID ) --- ---- ^
It is understood that, if there. is any change of status reggarding 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 -contractor notice.
CONTRACTOR SIGNATUR- 1tialifice)
Glenn A Davis 11
PRINT NANIE
CBC 1261228
CC)I� N'rl` CE It"I'IFIC_l7•ION iViJ>)13Et2
State of Florida, County of Martin
1
The foregoing instrument ssas si nett before the this day of
...`,?t7•'°;'by ti=C��11Y1. A D,RS .J4
who is personally known ✓ or has produced a
as icteniificaiimi. ,, � �p
Siguahi • of Notary Public
Print Name of \otgey Public
SIM-CONTRACTOR SIGNATURr•, (Qo-lifter)
David Price
ittiT N.ttlE
30191 St Lucie Co / CFC1430015 State of FL
COUNTY CERTIFICATION NU IRER
State oI Florida. County of Palm Beach
Tite foregoing instrument was signed before me this _^^ " da) of
20L _,btu
s
who is personally known _ar has produced n
as idetuitic:U1 n.
/ 1
STAMP
Signature of Notary Publi
Karl J. Hartel
Print Name of Notary i'ublic
p4 ° -'
Pu=e,,
Notary
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Comm�
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Revised 11;16!2016 �l�pFF��Q- 6ondedThru6udgelNoteryWyl-
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RHONDA S ROWS
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Commission #GG10A6ti6
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Expires May 19, 202ios