HomeMy WebLinkAboutChange of sub-contractor, plumbingPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGIN [A AVE
FORT PIERCE, FL 349.82
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERT
E'LEASE SELECT ONE OF l-lE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the net , contractor of record for the current permit, A new permit application must also be completed with new
contractor information and signattite. A new Noticc of Commencement must be filed in the new contractor's name
,for job values greater than $2,500 ($7,500 if AX Change -out). A recorded copy must be submitted prior to
coCHnci7ng any Mork. There is a $50.00 fee for flue Change of Contractor.
ANGE 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 S50.00 fee Pot• the Change of Sub -
Contractor:
CANCELLATION OF PERMIT - The cancellation of a pennit 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: L
Site Address: �(- , Z_C�_O_
Permit Nunrtber: Zoa�- - 63
t:�ktF-1i_.tFicr` E!-c. i �� � i ,,.. l�• � i�v�-i'�cv_t.
- d Ir C' State License f Li l�l 4LC License _ / �Z.- /.�.L.�� '�) r } � 1
6rigi4AI GC, subcontractor or owner/build
)1 ylc> i I---, C- State License (Fr.! (A-)t -5 SIX License
New G ', subcontractor
Reason for Cancellation rat
The undersigned does hereby agree to indemnify and hold harmless St Lucie County. its officers, agents and employees from all
costs, Pecs or damages arising from any and ail claims oraction for any reason; which may arise as a result of this change of
act 'subcontractor or cancellation of permit. A permit cannot be cancelled i �Iyric has been performed.
I S— _ - ----- — ---...__..._..._.. _..-_-_pptic--
C.±'`TATC!R6 t1P 011'tiGR {or oitimtdbuilder? SIC}NA'[lJtt}3 Gtil\ �1[ t'C)\1'RACTC>R (or now C7C, as itaUlc)
PRINT NAt !-__s 1Rt\TNAIMI... David Price -
_
State of Florida. (.otlnty of St. Lucic C'()uttty
The following instrument tails ackctowledged before cue. this
_-�ilay of 7Q�, $A- Ft el c�
�-_...Yho is personally known to nio
or w1 has prodwed
Signature of Notary Dote
6iec sed i.`4r 1 5 f,
oSQFy A�6( RHONDA $ ROWE
Gommisslon # GG 104656
Nag o= Expires May 19, 2021
Bonded TAN Budget Notary Services
Star.: of f lorida, County of'St. t.ucie Cutauy
The following instrument wasacknowledged bobs me I
__-;i day of 204)
to
me nr who is ploduced =_ as [1).
Signahcrc of \utary Date
L
v Pt
—v, Notary Public State of Florida
Karl J Hartel
My Commission GG 161385
ro@A Expires 11130l2021
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Hyppluxo Plumbing, Inc_ _ have agreed to be
(.Coinpany Name%Indi%.-idu it Naine)��—
the . Plumbing _ _ _ Sub -contractor for !&Z, ouilders, Inc.
(Tylic of Trade) _ (Printar}• Contractor)
For the project located at CIJQ(�v c� o)CA, �� I' .'
(Project Street Address or Property Tax Ill r)
It is understood that, if there. is any change of stattis 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 -contractor Notice.
CUNTRACTOR SIGNA.FUR . lualitier)
Glenn A Davis 11
CBC 1261228
COtrNTV CEICITFICATION NUNIBE11
State ofFloritia,Coon tyof Martin
l7ie foregoing instrument was signecl before nie this t. clay of
td ;
who is personalty linort n'✓ or has produced a
as identification.
Signatti of Notary Public
Print Natiir of Notary Public
SUIT -CONTRACTOR SIGN ATURr (f2ualincr}
David Price
PRINT NATNI
3W91 St Lucie Co / CFC1430015 State of FL
COUNTY CERTIFICATION NU-NI.RER
State of Pldridi'i, ('mPalm int} of Beach_
7 itc foregoing ins6 mucnt was signcri before me this (1a) or
nk
rd" bi
t
Who is personalty ]mown or has produced a
as ldentihCati ti.
I l
STAMP
Signature of Notary Pubb
Karl J. Hartel
Print Name of Nolan• Public
-0 Pue,� RHONDAS ROWE av Notary Public State of Florida
_� `' ° Commisslon # GG 104656 :� Karl J Hartel
* * 9 My Commission GG 164385
Expires May 19, 2021 �5eo� 6a Expires 11113012021
Revised 11;Ih!2016 NT9l'-"'Q�•r Bonded ThruBudgeiNotery$ervices