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HomeMy WebLinkAboutChange of sub- contractor, plumbing_ PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGIN [A AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT PLEASE 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 afrecord for the current permit. A new permit application must also be completed with new contractor information and signature. A new Notice of Cornmeticetnent must be filed in the new contractor's name ,for job values greater than $2,500 ($7,500 if AI(7 Change -out). A recorded copy must be submitted prior to coma] ncing any work. There is a $50.00 fee for the Change of Contractor. �t' 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 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 done. Cancellation of permit is to be signed and notarized by both the owner and qualifier cif record. There is no fee for cancellation of the permit. Date: � , Q Permit Number /,7 / 0 — OCR,? Site Address: t-D rtll ,.-�•�1;.)S't•��1�[tili�<-!"' ' � t--Lo State Liccnse t' �..C7 `- / LC: License /_ ?. Origi i GC, subcontriicic r or owner/build, Y C.- State License 5 SLC license New GC, subcontractor Reason for Cancellation The utxiersis ned does hereby agree In indemnify and Bold harinless 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; whieh may arise as a result of this change of 'act.Esubcoutractor or cancellation of permit. A permit cannot be cancelled i • ' irk has been perforated. -- U- U SIC3NATU26 C)F ()xx -for otv'l builder) S[CiNA'rl7[tF CiEly .r . Co11'RACTott (or IIeW Ci('., as applicahlc) PRINTNAX,11.:David Price State of Florida. County of St. Lucie County Siam of i�h)rida, Counts of Si. L.tieie Count;' The (ol►ow ing insinnncnit µds i)Ck11014Ie'dtd hiiore rues this The follow ing itrstnunent �e• > ;teknoah dged Uelbrc nie his, dayor_, - -,20. i)., ,<_isA Freld _Z d�tie)r__. - - 202�.uy- - _r� v-`L- ................._..___._._..._.L(._._.. _........ 1FIt0 Iti pelSUliall}' known to me — who is personally knocm to or ,dt ha, produced __as ID. me or who .n ducedas it). Signature of Notary Date Siguxture ur Wtaq' Rate Pay PUB, RHONDA $ ROWE. . E r?ry� No Public State of Florida * Commission # GG 10465fi c Karl J HertelOf Expires May 19, k21 c My Commission GG 164385Bonded7hruBudgetNotaryServlees 4e Expires 11/30i2021 PERMIT # ISSUE DATE PLANNING &. DEVELOPMENT SERVICES Building & Code Compliance Division BUII:DING PERMIT SUB -CONTRACTOR AGRi EMENT Hypplux© Plumbing, Inc_ have agreed to be (Cotnpony Name/Individual Narne) r the. Plumbing _ Sub -contractor for mar Builders, Inc. (Type of Trade) �— —T-^� (Primary Conlractor) For the project located at �l� ,`- (Project Street Addr s r Pr perw Tax In i0 It is understood that, if there is any change of status reyarding 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 SIGNTA,FUR Tttalitiee) Glenn A Davis II PRINT NANNIE CBC 1261228 COUN'IZ' UlUFFICATION NUXIBE11 stateorFlorida,Countyo Martin 't7tc frrrcgtiittg instrument was signcil Itcfore uic this i��- day of who is personally know i✓ or has produced a as idenjt�ification. /, Siguait • or!Nwary Public Print Name ot'Notary Public SUR-CONTRACTOR SIGNATURE (Qmdificr) David Price PRItr N:t1tE 30791 St Lucie Co / CFC1430015 State of FL ct)ttNT�cEttTir'iC;�TIUN s` t �I [siR Palm Beach State of Florida. Cminty of _ Tpc foregoing instrument was signed before me this ,. da} fir tJ bt t who is personally kn(mn or has produced n as idetititicatt n. s i i STAN[P S"I`1P Signature of Notary Pubii Karl J. Hartel Print Name of \otarc Public �ppY PUg RHQNDAS RQWEsR Notary Public State of Florida 4P Commission # GG 104656 Kart J Nartel # c My Commission GG 164385 N z Expires May t9, 2021 �1 o $a r;xpkes 11/3012021 Revised iIi10!2016 �9rFOFF�o�`� Bonded Thru6udgetNot8rY$6N1res