HomeMy WebLinkAboutChange of Contractor, plumbing 12.07.20sue"
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ERA7iT# 05-07 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
® Building & Code Compliance Division
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-- -• — BUILDING PERMIT
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SUB -CONTRACTOR AGREEMENT
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NORTHWEST PLUMBING / EDUARDO SAB(NA have agreed to be
(Company Natne%Individual Name)
the PLUMBING Sub -contractor for ARTAR CONSTRUCTION LLC
(Type orTrade) (Primary Contractor)
For the project located at 4452 N Hwy Al A
(Project Street Address or Property Tax ID f!)
It is understood that, if there is any change of status regarding otir participation evith the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice_
CONTRACTOR SIGNAIT ,-. (Ountirter)
Armando Reye Toledo
rRlrr NA%IE --
31143
COUNTI'CERTtt%tCAT2d:\ NU:113t:R
state of Florida, County
Tire foregoing instrument was signed before we this -1 dap of
'0 , 2(ab, by 4 ( ...^,^fi e
who is personally kno)vn _or has produced a
as identification.
5l'A�A'
Stgnatnrc of Notat�'ublir
Print name orNolary Public _ •.am T
EM
(, D je GIVENS
MY COMMISSION # GG D22023
EXPIRES, December 16, 2020
Boededl'hn►NotfltY�de�
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SC B-CU\TtL�!'fOR SIG\;�TiiRE tC}na►iGcr)
Eduardo Sabina
PIZINT N,1 1E
01140
f•QIiN71'CL•1217P'1GCrlON,l'[:.t)[)ER ' \ '
State or: lc, idst, County or r-�ayk t.,L t� -,6C a
•Cite fontioing instrument was signed before me this day of
r�E� �lr�' t , 20L`+`oY ����t'�1'1 �:l �-.Tst.tJ f, %l �'-'•
who is personally known _ or has produced a I
xseacntitiratina t ' F 1J yj I S i - ,,► U ()
of Notary
(� L'�• ;�aiE, JANNIREZ FERNANAEZ
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th►ir ftilgh FGlrlilaip 3.2024 1
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PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RECEIVED
2300 VIRGINIA AVE DEC" 0 7 1010
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578 Permitting Department
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
comm ncing any work. There is a $50.00 fee for the Change of Contractor.
7CHANGE 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: Permit Number:
n �
Site Address: f J�a A/
cT) e eF- State License SLC License
OrigifriIl GC, subcontractor or owner/buTder
State License(' �/l oULZ--SLC License 3� � �
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 Mcellation of permit. A permit cannot be cancelled if work b e n performed.
SIGNATURE OF OWNER (q'r owner/builder) P SIGNATURE GENERAL CO ACTOR (or)new GC, as applicable) n
PRINT NAME A'%, t(1tXA r1- 1'�/M' 1��Z) PRINTNAME `•�� `Y,l� 11\C AC• '
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of tK G , 20�jq by 4 inwo x
%.7 v e.5 who is personally known to me
or who has produced as ID.
Signature of Notary - Date
MOM 'E
22023
R ,, �5/0 COMMISSION J6
p020
pIRES: mubllcUnderw tars
BondedJW Not�Y
T—N following instrument was acknowledged before me this
_ --A---day of D It, c 2%& by 41 tn+k net t
R %-:. e S who is personally known to
e or who has prodpeed t— as 1D.
it Fe olnl+QbiQ SION # GG Ol >'
;i
o EXPIRES: December 16, 2620
"'•sgF F. $P'� Bonded Thru Notary Public Und?n;rt • r