HomeMy WebLinkAbout2008-0452- Change of Sub 0 J BU'LDIN lit ]DIVISION
ip • b I r 2300 VIR G INJA AVE
FORT PIERCE, FL 34982
(772) 4 -X 5 FAX 4 -1 78
C.HANGF f}F rnm-rR CTSUBCONTRACTOR OR CAN ELLATIMi OF PE%Mj-
PLEA E .C F. F TIFF. fiCIL i
_CHANGE OF CONTRACTOR—C hanIT of Contraaor is to be signed and notari red by the proR� rrt n�rner,
and the new contractor of record for the c urgent
hermit. A new permit appi.ication must also be com.ple,ed with new
contractor information and signature. A new Notice of Commlenocrrtent must be filed in the new contractor's name
fpr -Cob values greater than $2,500 ( 7,500 if A/C Chan e-0ut}. A recorded copy must }x, sr2bmitted pijnr to
commicTicin- any work- 1There is a $SO.06 fec for the Change of Con tractor.
)C CHANGE OF UBC{INTRAOTOR—Subcontractor char
ges The new subcontractorniLtt fill out a SubcorLtractnr A are to be completed by the general oontrackor.
ontr3ctor. Agreement f orm, There is a SEM.QO fee for the Change of SIR
CANCELLATION OF PERMIT—The cancellation of permit is 4cceptable only ifno work has, been done.
Cancel Iatiorn of permit is to be signed and notarized by both the owner anO qualifier of record- There is no fee for
eancellation of(Ike permit.
pate: 09/18/20 0 008-045
Permit Number-
.site Address: 116 (QUEEN CHRI T1NA T FT PIERCE FL 34949
HAWN WEI313-A Working Mans Electric t�t 31574
�Se License S[.0 f,ic�lse--
OrigilRA GC subcontracto rownerfbuilder
& 1N E State Licen EC13006897 ---,SLC Liccrlse
New G subcontractu —
Reason for Ft! Change of sub-contractor---Reason - scheduling conflict
i he undersi ucd does hc:.rcby agrtc Lu indemni fy and void hannic St Lucie County, its ofiicers,agents and emplo} s ff orgi al
costs, feet or darnages a ing tfont any and a]I claims of action for any reason, which may a " as a result ofthischangc of
uontr risubc f permit- A permit cannot b an eel led if work s been performed.
ATLfRE OF 4 or awner16uiklcr ti TLJFt�(iE= lx R{or new
FRTNT I{r ,s` PRINT1 AM
$lain of k County of St.I ueic Co" Stale of County of St.Lucie fiaunry
The fo owing in omcm vyw acknuwkdged hefofe roe this .1 foll inStu rnt s acknowE before me this
who is per-yonaLly IrnoKm io me who it persamlly known to
ur aicu has produr. L— Las ll). or Who has Rraducai � � �—
t' 0911812020 J 1 1 0 0
Sign#IUrk`orNotary note $igKiMurr.Ofvolairy Date
Revised Q4 ,5JJ6
........ ADhMA RAYA
�'_ i Notary Pubs•Stahp of F[01k
CcHwizion 0 GG 464625
Y. rotary_ 31sc 5tatr of Fdorlda d. Y Gomrnissia�r A GG 954625
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