HomeMy WebLinkAboutChange of Contractor 5r
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rg a� ST. Lucie Coun ty, Permitting
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_CH GE OF CONTRACTOR
poptpiptqr or Cancellation pf Pdniit
.Ghanp ofcontractor 10.to lie coinpldfed'by the--:property owner,and:themcw contractor for
obfk6fitffil&f Alift pet' .must also be dted with new -ddnt-tAct6r ldfbrlp&tSn.
signature,:rid.t>,ansfet fee. A.ne,v'Notice00 nmendement.must:be filed'.in the new-contractorls
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name for job valdes gre-Wrlhki S2,500,(ViW if A/C QfMig&dut). A-i-b d
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Subcontractor-changes can mi d Pi or,id-ton rn nclng..py work S4q be completed by:the general
submitted,
an b"rii dand laddh:-6f 0
contractor.. Abseiit'bxt6h;tidti eited t' it.19 tb ' e..bxddlited"b,.V_h th the
Date, 36192020, F&Mit Nu mbdf- 1112--MOO.
Site Address: 0 fF�VAitsIA Ml
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bdarl' bonn6cddh `License ECo ct 29 313SW-LIcense,
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Rek9oh-R&Cliange OFiginaLtrade tirillnot COMOe''t-ewo.rk
The dtiaeffi d gtid h6ld-hArinlessi-St.Lucie Cbiw y Jis Officers
gtidd ._0d§.hdreVyg a.rd
'Tees,,&ddind "e-sk' l'i"Ins 0 ge toll Or
-agents,.and employees froi-w allcost,% �Afisilfk-`R6�1_.a any. - , i ,i
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$0 1 p"Whi-h --i- .this .0 ubpon
..anyt 0.. .......*�liangO' f contr66torls c Wic.tor br'd cellation of
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ACTOR f SIONATURE.OF-NMWGtk_E�C0
:CVM RO&O get) 'PRINT NAME:&-c-,--L,
Stfit66fFqifi.da(;,CoWity.df SliLeib County -Stald of Florida,C(n*ybfSL hicid CouRty
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ng�lnmruPAeA.tvas.9c.n -fare-pip ljps_
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Kevin ljorkenhageR :who is pqrso afty know tome. vih j3persona"llikuqVI -me
orWh6hasproduced' 4m-ID. or foil d ID. x
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slunnfure dr-gotary 1)aft • we
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Only' signature 'requited fox changd of su4contractor
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