HomeMy WebLinkAboutChange of sub-contractor, plumbingPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
® n'' 2300 VIRGINIA AVE
e
FORT PIERCE, FL 34982
(772) 462-1.553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASI? SELIRCT ON) OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
Lind the new contractor ofrecord for the current permit. A new permit application must also be completed with new
contractor information andsignature. A new Notice of Cornmefrcetnent trust be filed in the new contractor's name
for job values greater than $2,500 ($1,500 if A/C Change -out). A recorded copy must be submitted prior to
corns'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 a S50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERN11T — 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: CA., t,A A 0 Permit Number: a 003 - 00? 3
Site Address:
V c Ftt tC{ram F 'C', Vi
) fir tC# i )) v1r1 Y1 State License
i•tgj~�L lLITSLC Lucnse�.%,<._/�
Oi l GC subcontractor or owner/build
0 (13tt ti V1 Yg l t'A C-- State License ('l (_ i ae( (: t `3 fiI.G License 't-`'7 `7
New GCf, subcontractor.._ --
Reason for Cancellation �2A
The undersigned clues hereby agree to inderini lip and hold harmless St Lucie Counts•, its officers, agents and employees from all
costs, fees or damages arising from any and all claims ofactiun for any reason; which tray arise as a result of this change of
GePA act ?subcontractor or cancellation of pennit* it permit cannot be cancelled" i ` trk has been performed.
$IG �TAT11R6 C)F ()t4 NL':R (or o« ni cbuilder) SIGRATUR}.: GU ,r t'C)\"CRA('1't)R {or new tlC, as applicable]
RTlvT NAf-12 (J j'Y. pxlvT�tr��Il .,David Price
--h_aL -__ ------------- --- - - --
State of Florida. County of tit. Lucie County
The: following instruincm was ackno,rlcdged before we this
7o ZU.bv-..�-� Sk! Fteld
. _ .,._._ ._who is peisonally k7town io me
ot-to ha, produeed its 1D
_
_. _._ _ 15�,_p`,, _.�'1 melee✓ _._..._._.__ _..
Signature of Notary Dote
F:c;i�_ci i'4r t'•i _b
2OW Pik, RHONDA S ROWE.
* * BonCommission # GG 104A656
NT r Expires May 19,'2021
yr1Of.Ov dedThroBudget Notary Services
State ofl�htriCla, Counh o#'Si. t.ucieC:rnntty
The rollotsing irisupment wits ;acknowledged bel'orc me tty ,
by ''Dl�,C_Gr_ _.i-'1r
who is personally knonat to
me or wlio is pimured__—__ as tD.
Siguahtrc of \otan• Uafc
�o,O%v Pp#, Notary Public State of Florida
Karl J Hartel
N a My Commission GG 164385
•roh��01 Expires 11l3012021
PERMIT #
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Q- o
BUILDING PERIMIT
SUB -CONTRACTOR AGREEi41EYF
Hypoluxo Plumbing, Inc have agreed to be
(Company Name`Individuat Name}' iZe �a
the Plumbing _ Sub -contractor for r Builders, Inc.
(Tyl)o of Trade) ^` (Prin><3ry Contractor)
_ 5 v
For the project located at 5a e
(Project Street i dd ess o Property Tax II7 )
It is understaod 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 -contractor notice.
CMTRACTOR SIGN1'1't R . ?nalificr} SUB -CONTRACTOR SIGNATURP (Qualifier)
Glenn A Davis 11
I'RT\'I' ti:1\IE
CBC 1261228
COITNTY CF:MIF'ICATION NUMBER
State of Florida, Con!ity of Martin
17ie rnregiiiug instrunnnt was signal licfore uie this j✓� day of
--= "tom•• . ..
who, is personally krtoscit'✓ or hats ftroduced a
as identification.
Cignahi of Notary Public
Print'Minen1'Cotary Public
David Price
PRUNT NANIF —
30791 St Lucie Co f CFC1430015 State of FL
Cot=1TYCElir[F7CATION NIiII[3Eli
Palm Beach
State of Florida. Ciriinty of.,
The foregoing instrument was signed before nic this _ day of
who is personalty known or has produced a
as identillCa(i n.
1 l
STAMP enu
Signature of NoL•try Piibli
Karl J. Hartel
Print Name of -Notary Public
�PpY Pllg RNONDAS ROWSsv °+ Notary Public State o[ Florida
r' .••'•�«e''? >�; Karl J Bartel
* Commission # GG 104656
Ex Tres Ma 19. 2021 r�r= o-Q My Commission GG 164355
P y 5tos F
A0 Expires 11/3012021
Revised 11.16/2016 N-9lFOFF�p�`o� Bonded ThruBudget Notary $eryices