HomeMy WebLinkAboutChange of Contractor\ - $ Sd . 0b
Planning & Development Services
- Building. & Code Regulations -Division
'COUNTY2300 Virginia Ave.
• Fort Pierce, FL 34982
(772)462-1553 Fax 402=1578
CHANGE OF CONTRACTOR.'
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
Signature, and transfer fee: A new Notice of Commencement. must be filed in the new contractor's
nave for job, values greater than $2,500 ($7,500 if -A/C: Change -out). A recorded. copy must be
submitted prior to commencing any work. Subcontractor changes, can be completed by the general
contractor. Absent extenuating circumstances,' a cancellation of permit' is to be executed by both the
owner and qualifier of:record.
Date. i0 l aq i+�7 Permit Number: J!jjo�S —D%SJ
Site Address: -
Auga Dirnensiohs Plumblrig State Li6enSe CFC05728 SLC License 15828
Original General Contractor (or Subcontractor)
One -;Stop Plumbing Services, -Inc. State License CFC1436081'
New General Contractor (or Subcontractor),
Reason for Change wrong contractor' submitted
SLC License
The undersigned does hereby agree to indemnify and hold harmless St. Lucie County, itS officers,,
agents„ and employees from all costs, fees, or damages arising from any and -all claims of action for
any reason, whgh may arise as a result of this change of contractor/subcontractor or cancellation of
permit. Aperrgit carinot.be•cance ! oxk has been performed.
SIGNATURE
PRINT NA@
State of Florida, County of St. Lucie County .
The following instrument was acknowledged before me this
day of 2o- b
1 know t
or w has produced - as
Signature of Notary Date
*Only signature required for change
Revised 0.7/21/14
* S OF--NNEEW GENERAL CONTRACTOR
PRINT NAME .JU3b�e�wtrS
State of Florida, County of St. Lucie Couhty
The following instrument was acknowledged before me this
281LdayofC)_ ohPr';20M.by .1aS011 James
who is personally know to me
(oarh,o-bas'produced as ID:
44
s1gn,tQ.fN t ry Date
of subcontractor Y Angelique Matthews
NOTARY PUBLIC
-+STATE OF FLORIDA
= Comn* FF95802
�•s/ CE 15�� Expires 21812020