HomeMy WebLinkAboutChange of sub-contractor, plumbingPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGIIVIA AVE
,g FORT PIERCE, FL 34952
(772) 462-1553 FAX 462-1575
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERNTT
PLI:ASI3 SELECT ONE OF TIIE FOLLOWING:
CHANGE OF CONTRACTOR- Change of Contractor is to be signed and notarised 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. Anew Notice of Conimeitcement must be filed in the new contractor's name
for job values greater than $2,500 ($7;500 if A/C Chance -out). A recorded copy niust be submitted prior to
comp Hein, 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 at $50.00 fee for the Change of Sub -
Contractor:
-CANCELLATION OF PERMIT - The cancellation of a pernit 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: q - a > &)
Site Address:
Pe1•nlit iNuniber: a_c,,3 -15
t: tu:aCt[*rr r c>t, •",ti t, t:1; i t"-.��c r --
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���Atl I t )C State Licen'f-
se 5 7 17 SLC License _Z/,2- 2-
Origi 1 GC, subcontractor or buildcrJ Ci r ; � �, t t�
1. :k> 1 ki 'X t.
New Ci ', subcontractor
Rcason for Cancellation '2A
The undvr5 fined does hereby agree to indemnify and Bold harmless St Lucie County. its officer's, agents and employees from all
costs. fees or damages arising from any and all claims ofaction for any reason; which nrty arise as a restdt of this change of
A permit cannot be cancelled i
act . /subcontractor or cancellation of permit. •:ttrk has been pertornied.
SIciNe\TC!R . OF(?tGtirR f or nwnet builder} SI(i �A'RJRF GEi� . C'[7\1'tiACTC)R (or nets CiC, as applicable)
F I1: ia:1t- USA.1PItIT Vr\lE._ DaV1C� Price
---
State of Florida. County of St. Lucie County
The following iustrrrmmu was acknowledged before we this
cP dtt<Of- 1
20_&).b �C SA �rel�
..----
._- rho is puaonally known to two
or wko
hka, produecd _..---
:is 1D.
Jz
{�
Signature of Notary
Date
Y 10410r RHONDA $ ROWE
o4
Commission # GG 104666
N� o� Expires May 19,`2021
1;0,1P
Bonded 7hruBudgelNoter/Services
State of Florida, Count% of St. Lucie Count;
The follow ing histnmtent was, ncknowkdged 1) t¢ 1A - Inc th ► 2�Ci
2i121.2,
to
�Signaturc
nr a ho as ptrduced- — of Notary Date
}opsr Po Notary Public State of Florida
Karl J Harrel
goo-My Commission GG 164385
Expires 11/30/2021
C
PERMIT# ISSUE DATE
PLANNING &. DEVELOPMENT SERVICES
Building & Code Compliance division
Hypoluxo Plumbing, Inc
the
(TYpe of Trade)
BUIIlDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Rnar Builders, Inc.
(Primary Contractor)
For the project Located at _q.5�
(Project Slrect Address or Properey Tax ID r)
It is understood that, if there; is any change of status regarding our participation with the above mentioned
project, the Building and Code Regtilat'ion Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor Notice.
CON'TRAC:TOR SIGti 1'RM . Yualifier) Sled -CONTRACTOR SIGNATURr (Qualifier)
Glenn A Davis 11
PRIM F iY:\tIE
CBC 1261228
COU\TY CER'ITFICATION NUMBER
State of Florida, Coapts or Martin
'nee foregobilt instrument was signet. before we this { � day of
ga ;,
t
%Vho Is personally krio`s'n ✓ or has produced a
as idettificatiou. .
Signaou of Nntary Public
Print Nauic of Nolaty Public
David Price
tINT NAT iE
30791 St Lucie Co / CFC1430015 State of FL
COUNTYCEIZ7FIVICATION NUNHWi
State of Florida. Coulity of Palm Beach
The foregoing instrument was signed before me this da) of
who is personally known _or has produced a
as IdCillilipl(1 fl.
1
STAMP
Signature of Notary Pubb
Karl J. Hartel
1'rint Name of Notsrr Public
SppY+PUe�� RNONDAS ROWS �a� ° =Hkairtel
or Florida
2° ' �`" ° Commission#GG104656 c tn4385Expires May 19, 2021 Wda
Revised 1116/2016 NT�rFOFf�°A�oz BondedThruBudgetNotery$etvlces