HomeMy WebLinkAboutChange of Contractor, plumbing, 12.07.20PERMIT# 1 ®m®7 /8 ISSUE DATE
- -- PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
s �
- - BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
NORTHWEST PLUMBING / EDUARDO SABINA
(Company Name/Individual Name)
the PLUMBING
(Type of Trade)
For the project located at
RECEIVED
PF.r 0 7 2020
Permitting Department
St, Lucie County
have agreed to be
Sub -contractor for ARTAR CONSTRUCTION LLC
(Primary Contractor)
4500 lu Hwy.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 Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
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CON'rltAcroitSIGNATtJIZE ualifier)
Armando Reyes oledo
PRINT NAME
31143
COUNTY CERTIFICATION R
LLNUNWBE
State of Florida, County ot!
The foregoing instrument %vas signed before site this -1 day of
t)e,c ,2c� .byAcrNg•,.,aa t.meS
who is personally known _or has produced a fU' 0 1,
as identification.
identification.
Signature of Notary P&dlic
.Avxk d.\')-S
Print Name orNotaty Public
N.......... DFNAMARIEGNENS
-�- MY COMMISSION ik GG 022023
t 1lr cRl�€S: Qecembet 16. 2020
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SUB-CONTTtACrOR SIGNATURE (Qualifier)
Eduardo Sabina
'RINT NAhll'.
3t t 4v
COUNTY CERTIFICA7't0\ NUNIRER
State of Florida, County of CL¢bt Ok
The foregoing instrument was signed before me this 013 day of •
t cep L-91
who is personally known or has produced a� Df tCL dT 11/0--r—
L i C9-M- P -*S �► g)---9 00-6v 8-09-7
as identification. ,
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Sig talnre of Notar} Pu fie y ft'sslm�l9elon//QG915q9d
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Print Name of Notary Public
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 RECEIVED
(772) 462-1553 FAX 462-1578 OR -0 7 2020
I
Permltting 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.
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'PERIVHT — 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`I 1 a -a Permit Number: 1905 — 102 7
Site Address: �-ad l4
r
!! r'rilyl e State License SLC License
Origin GC, subcontractor or owner/Wilder
A G,IaCurolam SCE �'lc'j State LicenseCRC 1429L}JSLC License 114-0
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 canwqation of permit. A permit cannot be cancelled if work has performed.
SIGNATURE OF OWNER (or o er/builder) SIGNATURE GENERAL CO CTOR (or new GC, as applicable)
PRINT NAME j%YI �� PRINT NAME -D � I
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
—A—day of �� 20 byAL,��
`c �7 who is personally known to me
or who has produced L i() L as ID.
Signature of Notary Date
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MYCON S'10 �#p�Gt 1S.?,
Bo��1�N �linden01are
The following instrument was acknowledged before me this
day ofoeC 2b}d by f --.A a
L"J%" who is personally known to
who has
Il
Not%MNAMARIEGkR8W
MY COMMISSION # GG 022C.':'
EXPIRES: Dgwrnbor 18; 2iY;
eandedThru Notary PtJbilr,11r.;?:+ `