HomeMy WebLinkAboutChange of sub-contractor , plumbingPLANNING & DEVELOPMENT SERVICES
- ' BUILDING & ZONING DIVISION
�� 23010 VIRGIN[A AVE
r FORT PIERCE, FL 349.82
(772) 462-1553 FAX 462-1578
CIiANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASI SELIXT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner.
and the new, contractor ofrecord for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Conimencetnent Must be fled in the new contractor's name
for job values greater than $2,500 ($7,500 if AIC Change -out). A recorded copy must be submitted prior to
concing any work. There is a $50.00 fee for the Change of Contractor.
7CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor mast fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub -
Contractor:
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been (lone.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: "! • a. I O.W Permit Number: �— 00 7-
Site Address: �J/ 02Am. �Q Q 7 0 " jlJ erC�,
-' l_.tr .O � C` State License it-C--a I`�7 SLC Luense�: /_2._
Origi 1 GC, subcontractor or owncr/build� f� v t r� P1 i
`! c.
1. *su nt a t...1 C State License (TT-1 i 1.,�t_ t. 23 SLC License
New G ', st.ibcontrt►ctoi
Reason for Cancellation ''211
The undersigned does hereby agree to indenmify and Hold harmless St I..ucie C'tiunty, its officers, agents and employees lrnm all
costs. fees or damages arising from any and all claims, of action for any reason; «•hick nrty arise as a result of this change of
-
act !subcontractor or cancellation of permit. ii permit cannot be cancelled i ' rk has been performed,
C)F 0�1 NFR (or otvn�r,builtier} 5[Ci\A RJRI Gtil\ C7O\1'RACrOR (ar nciv C;C, as applicable)
i'? T?1` NAI �.._$A �,_� D_ PRINT NAJ'!r._; David -._Price --
Stine of Florida. County of St. Lucia: County
The following instnitnent nas acknowledged before me this
—d iV of S e�.t 204 . by, 1.-1 SA- Fi'e1 d
giro is personally knoian to mo
(i i%lio ha ptodut�tl as ID.
_ _ Gil .__... _ ��,��--•,_ .._._. _....
Signature of Notary Date
RMONQASROWE.
* Commission # GG 104656
N, c� Expires May 19, 2021
9l10"'-Q�. Bonded Thru Budget Notary Services
Stara of Florida, County of St. Lucie County
The follounit iiutnunui wa>;rkno�.vledged betitre nu jhi:
of _ ,. __ 2(ZQ by__-- 1C�fll� i� 1 C C-.)
who is personally knouii to
me ar aho as produced its I1)..
Signxhirc of \utan• I)alc
.J
=oonr Py#, Notary Public State of Florida
Kari J Hartel
a My Commission GG 164365
9it�moo' Expires 11/30/2021
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Coinpliance Division
BU1.11DING PERNIFF
SUB -CONTRACTOR MMtf EMENiT
Hypoluxo Plumbing, Inc have agreed to be
(Company Name.iffidividual Naine
the Plumbing Sub -contractor for Rnar Builders, Inc.
(Primary Contractor)
For the project located at
(PrOject Street Address or Propeny'Nx 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
filhigr, of a Change of Sub -contractor notice.
CONTRACTOR SIG NNATU RPTQualifice)
Glenn A Davis 11
CBC 1261228
COUNTV UIC11FIC-ATION NUNI BER
statt or Florida, Coallty ol'Martin
Ilic roregoling, histrunient was signed before Ine this (Jav of
A io
who Is persolinl1v knots n%/ or has produced a
as i(leWiricatiull.
I L' ongd,
R1. iatntv-of Notary Public
il—rhit Naii)6 ot'Notney . Public '
SUR-CONTRACTOR SIGNATURr (Qualifier)
David Price
PRINT NAAW
30791 St Lucie Co / CFC1430015 State of FL
COUNTY CEWFIRCATION NUMBER
Since of Florida. County of Palm . Beach
I'llerijrcgoijiginstrument was si;nett beroreiie tills (la)nr
who is persnualty known —or has produced a
STANIP
Signature of Notary Publily—v, -j
Karl J. Hartel
Print Nome of Nolary Public
o 'VSv pt"ge RHONDA 8 ROWE Notary Public State of Florida Karl J Hartel
MY Commission GG 164385
Expires May 19, 2021
Expiriis 11/3012021
Revised 1 l,'10!2016 sonded Thru Budget NotarY Wilre5