HomeMy WebLinkAboutChange of Contractor, plumbing 12.07.20PERMIT # 11901-0544 ISSUE DATE
9COUNrY
L Q ti I D A
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PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
RECEIVED
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT DEC'm 7 2020
Permitting Department
St. Lucie County
NORTHWEST PLUMBING / EDUARDO SABINA have agreed to be
(Company Nameflndividual Name)
the PLUMBING I Sub -contractor for ARTAR CONSTRUCTION LLC
(Type of Trade) (Primary Contractor)
For the project located at 4446 N l-'.',vy A -I A
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code RegulationDivision of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTORSIGNATURE ualilter) SUB-CONTt2ACT ZS1G.`ITURE(Qualifer)
Armando Reyes oledo Eduardo Sabina
PRINT NAME I PRINT NAME
31143
COUNTY CERTIFICATION NUNIRER
State of Florida, County of 5Ar. . LL%� C \�
The foregoing instrument was signed before nee this _:]_day of
4c,-.
who is personally known _or has produced a
as identification.
Signature of Notary lalic
�, t\ r0. (:S—\y -,
Print Name of Notary Public
i
+�. E GIVENS
MY COMM SS^IO # GG 022023
=*i ` EXPIRES, December 16, 2020
%}°'t tlG" N Notary Pcblic Underwriters
_3 ( Y `1'®
COUNTY CERTIFICATION NUMBER
State nt''lnrida, Counhof �! Ce�'►'ti �ei.C�L� '
'Me foregoing, instrument was signed before me this Ct-- day of
belVIPOAPI).29gOby_CC�rCaljDSCc6
who is personally known _or has produced a I~ /D/' j dole
as i catiRcation. Sl i t� IlP- t� L /�7�
1W6(v I Ul STAMP
SPgna nrcafNohtt ubtic t�4tvv�g dANNIREZFERNANDEZ
CommlS8100GG925464
a to iY161 (+Expi 0 0bmary 3, 2024
Print Namc of Notary Public oaf! tYe IMattrySarAM
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PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RECEIVED
2300 VIRGINIA AVE DEC® 7 1010
FORT PIERCE, FL 34982 Permitting Department
(772) 462-1553 FAX 462-1578 St. Lucie county
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
co encing 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 must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of; Sub -
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit 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: �`1 `a b Permit Number: 190/ 015Y
Site Address: 7 7 /V
Aa
(1r7 Ct �'✓'r j1 State License SLC License r
Original GC, subcontractor or owner/builder
�it41AM d O St- f�l State License Cfio J 4-V/7-7%LC License
New GC, subcontractor
Reason for Cancellation
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, which may arise as a result of this change of
contractor/subcontractor or p0pellation of permit. A permit cannot be cancelled if work has be rformed.
SIGNATURE OF OWNE_ R r owner/builder) SIGNATURE GENER/AAL, CONTRAC OR (or new GC, as applicable)
PRINT NAME �t^ iif/Vi (X�L� �%] ¢} I//j PRINT NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
—a—day of 1�C1, 23 byat"`a`hati
who is personally known to me
rorwho has produced YA- 0 t— as ID.
Signature of Notary Date
Revised 04/15/16
State of Florida, County of St. Lucie County
The following instrument was ackno led ed beforeine this
A —day of b9,c. 20[_by_! sC Ao a a
who is personally known to
me or who has produc L- as ID.
Signature of Notary Date