HomeMy WebLinkAboutChange of plumbing subcontractorPERMIT # . � ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMY1'
UB- ON7'FLA 7'0I1 AGREEM NT
Vision Plumbing, Inc_
(Company NanrAi fividual Name)
the plumbing Sub-contr-4aor for Pace I�I�0, IllC-
(Type orTradc)
(Prin u'v Cordnictor)
have agreed to be
For the project located at ` - ! i'� { _ l � � '� P1ff
(Project Street Addre or Property T&,; rD 4)
It is understood that, 1fthere is any change of status regarding our participation with the above rn, ri .oned
pr-oj eM the Building and Code e U, Aon Division of t- Lucie County will�vised pursuant to the
5 I i n g of a Change of S ub-contractor not-] ce.
C.0 N- TRACTOR c;1(.NATUR1E (Qualifier)
F.,.TI O17M0 , P1 rT,
PRINT NAME
CBCO59859
UOUNrY[ERTHrIC'ATIQNNUM ER
State of Florida, ( aunty of ,
11w foregoi i"rwmcf t wwa signed hcfnre me Ih�ti cbky of
2 � � OA0i
who is peisomttt known >( or his produced a
As-A'U
iei4��ririt In�M
'�S�sture of �l�ry P
Print Name of NoEary Public
SIGNATURE (Oualificr)
PRINT N
F 1426848
COUNTY CERTIFICATION 1VUMBER
fitstc of ! laridu, C'ouri l of a
11x furc-ping iuslrgzkwM was stpmed Before me #ris EL day of
Y 2a) hY
who is ptrsonml�y Iahwsn X1 or hw• produced a �
aR idrntiflratiwL
STAMP &Ld0_S.- A'Uah)
SSgnature or NoUiry
Awa S- E
Print lk ne orNolary i'umc
Pauka S. Brew
�r-'7'" Carom.#�141�3���1
;�, BOW Aaron N:"
►r Pam S. Dreier
Comm.#HH031961
Fames: Sept` 15, 2124
B=W Thru AWN "
ti I'.+ M P
revised I if I e2016
PLANNING c DEVELOPMENT SERVICES
BUILDING & ZONINGDIVISION
COUNTY :
23M VI GI IAAVE
FORT PIERC E, FL 34982
(77 ) 46 -15 3 FAX 46 -X 578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECIONE OF THE FOLLOWING -
CHANGE OF C;ONTRAC;TOR — Change of Contractor is to bu signed and notarized by tho property o)Nncr_
and the nmv contractor of record for the current permit. A trot%. perrnit application must also be completed with new
contractor information and signature. A new Noti c of Cornmencenient must be filed in the now contractors name
for job values grcator than $ .,500 ($7,500 if A/C Change -out). A recorded copy mast be subrnitted prior to
commoncing an work. There is a S .00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor_
The now subcontractor must fill out a Subcontraetor Agre mcnt Form, There is a 50M fee for the Change of Sub -
Contractor.
CANCELLATION OF P ER MIT — The cancellation of pennit is acceptable only if no work has been done_
Cancellation of permit is to be sig=d and notarized by both the owner and qualifier of rocord, There is no fee for
cancellation of the permit
Date: 11/512020 Permit Number; 20080127
Site Address: 11057 S. Indian River Drive
Patriot Plumbing, Inc- Statc Licc:nsc CFC1428878 SLC I.Lccrlsc
Original GC_ subcontractor orownerlbuilder
VWon Plumbing, InC,
New GC, subcontractor
License F1426848 SLR' License
Reason for Cancellation charge of piumb1ng s u bco n l: ractor
The undersigned does hereby a;Tee to mdemnify and hold harmless St Lucie Conrity, its officem agents and employees from all
costs, fees or damages arisi.ag from any and all claim., of action for any reason, which may arise n a muilt of this change of
uontricterlsubc mraQ for or car l lativn of permit A permit cannot be cane work h
SK ATUfRF, OF OWNER (or Gvunerftilder) SKINAIURK CIxNEP-AL OOMRACTOR (Cyr riew CiCy, as npphc:ahle)
PRINT NAME PRINT NAME
Sule of ClcaickL Cuwsly of St [u+:ic Cinmov smw cif Ilmdk Comly oN. LUCIG COMT3,
the fbllovring. instmmait Am aebto{vladged befoTeme Ihis
dayuf _ _,- 2u_,by_
kvho is p`'l"afly knovm Ix) me
OF LkjSU hM, W0dLK;,X1 as 11).
11 l6I2020
Ngmture or Noun Dof
Rkkvi:jc'4
'flrc follrnving in, mcnt v.As ac},mrmlcd bc' to thi
dayof� ,20Mby
i 4 t 1 Vh3Oi9 pC19f11 alk-1,nMAM tO
cu tto ha J ID.
� J15W20
atw-e of ohtn llntc
A"p"Iw Paula S. Bar