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HomeMy WebLinkAboutChange of Subcontractor- Electrical Bldgs A-FPLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTM SUBCONTRACTOR OR CANCELLATION OF PERMIT 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 52,500 ($7,500 if A/C Change -out), A recorded copy must be submitted prior to commencing any work. There is a $50.00 fee for the Change of Contractor. X 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: 2 /2021 Permit Number: Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 2010-0252 Arlington Electric, Inc. State License EC13007767 SLC License 30840 Original GC, subcontractor or owneribuilder Biyco Electric, LLC Stale License EC13001240 SLC License 31779 New GC, subcontractor Reason ror 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 contract or/s contractor or canof permit. A permit cannot be cancefl if work f been Performed. S1GNA rURE OF OWNER (or otvnerbudder) SIGNATURE GEN •RA . CONTRACTOR (or new GC, as applicable) PRINT NAHF. PRINTNAME �t State or Florida, County ut� State of Honda, County of St Lucie County Thefollowing insaument was acknowledged belbre me this L� ` p`` day of YZ-2U k . by�� 5 2 e! _ ,-who is personally knower to me nr ho produced as ID. t-►_ 27ttl2021 Signature of Notary Date Revised 04/15/16 �;,YAL� JODI L PETERSON Wary Public - State of Florida • .z Commission t GG 072280 My Comm. Expires Feb 12, 2021 '�O`fl'� 9fsrdedlhroughtiafionalNat:ryAun. f Ilowing rent was acknowled ed on_ a this y of i by� wha is or•rsonally known to - who has Produced z s ID. ~ Sigtnture of }i ► + t ' —'BONNIE A. DIXON FIDOda +P; i 1 ry Notary Public • State of Q? Commttslon 9GG 2,4365 t• ,Pt My Comm. Expires Jun 9, 2022 Bonded through Nation&'. Notary Assn, PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERINIT 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 $2,500 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work. There is a S50.00 fee for the Change of Contractor. X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor. The new subcontractor must fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERINUT — The cancellation of a permit is acceptable only if no work has been done_ Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: 2/8/2021 Permit Number: 2010.0267 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Arlington Electric, Inc. State License EC13007767 SLC License 30840 Original GC, subcontractor or ownerlbuilder Blyco Electric, LLC State License EC13001240 SLC License 31779 New GC, subcontractor Reason for Cancellation The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor -sub ontractor or cancellation of permit. A permit cannot be cancelled If w)pric has been performed. SIGNATURE OFOWNFR er) (orowner'builde _ —� SIGNATURE GFN�GRnAL CO� RaCTO/R {urnew GC, as applicable) PP ENT NAMEI :jkev,�_-. PRINT NA1IEvl� State of Florida, County orft ty The rollowtng instrument was acknowledged before me thus ,!ayar QA-,� 20014 by t kVf•� who is [erson4! known to me or who has P3Ziduixd as lt) 218/2021 Signature of Votary hate Peaased 04 '1j:: ;.,� �P"''•,, JODII.PETERSON Notary Public, State of flofida . ; z�i�ovft ,.•' Commission i GG 072280 My Comm. Expires Feb 12, 2021 gan&dthMghnahWalWaryAoo. State of Florida, County orSt Lucie County wing m I. acknowledged before me this � �} dro�f�/ Zr'-D�-$y f vj. Gi� L n I '/Who.ss_aersonally known to -m r Who has tmxtucod Signature of o , V , L' A.1)OtON notary Public • State of Florida Commission N GG 214365 GF, My Comm. Expires Jun 9, 2022 Bonded through National Notary Assn. PLANNING & DEVELOPMENT SERVICES - - BUILDING & ZONING DIVISION 2300 VIRGENIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT 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 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work. There is a $50.00 fee for the Change of Contractor. x 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 PERIMIT — 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: 218/2021 Permit Number: 2010.0271 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Arlington Electric, Inc. Original GC, subcontractor or owner/builder 13lyco Eleclnc. LLC New GC, subcontractor Reason for Cancellation tate License EC13007767 SLC License 30840 License EC13001240 SLC License 31779 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 contracto r subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. 5tGNArt!RL0I.OWNt_R(or ownerbullder) SIGNATUPEGENE I. TRACTOR (or new GC, asapplrcablel PRINT NADIR t`. t 3 PRINT NA,NIF OW 1A State of Flonda, County otxrr;xurty The following instrument was acknowledged before me this iL day of 20_�:L, by kA_> - who is personally known to me or who has�nxtuced as ID r" 202021 Signature of Notary Date ,e•�„p. JODI L PETERSON P.evised : 4, 1-`1fi ¢1Notary Public -State of Florida •. Commission#GG072280 +; My Comm. Expires Feb12,2021 aOp IlmdedthreughNationalNctaryAssn. State of Fbnda, County of St. facie Count) " In r t was,u aged before me this Y L 'Aho i_s0rr 0211Y known who has produced s ID. / .. %7Natlonal Signatureaf,�at NaWf Vicrida Comm365 rho AAy Comm, 2022 Bonded througry Assn PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE -OF CONTRACTOR, SUBCON"I'RACTOR OR CANCELLATION OF PERUNIT 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 (57,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work. There Is a S50.00 fee for the Change of Contractor. X 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: 2/812021 Permit Number. 2010.0274 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Arlington Electric, Inc. State License EC13007767 SLC License 30840 Original GC, subcontractor or ownerfbuiider Blyco Electric. LLC State License EC13001240 SLC License 31779 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`sub ontmctor or cancellation of permit. A permit cannot be cancelled if work has been performed. SIGNATURE:OFOWNER (or nwnevbuilder) SIGN:%TURE GE R:1L CO TR.ICTOR for n�cw GC, as applicable) PRINT NAMErC' c +: PRINT NAUkIE State o f Flonda. Coutny or t,,18=_. The following instnumrit was acknowledged before me this day of IF-L. 200�, by V� who is personally known to me or who has produced. as ID. 2/8/2021 Signature or Noma Date Revised �J4/1S/10 �'� 1° ''= JODILPETERSON Notary Public -State of Florida Commission t GG 072280 =,hy My Comm. Expires Feb 12, 2021 amdedlhro*NatkmWNotary AsvL State of Flanda, County of St Lucie County Jp wingy of�, ,c a bbYgcd before me this ✓�����w�lly kn.wu,_knowu,._ nr-who has pwiluced as ID. 6 20 Signature or ti Y' ONNPEA. DIXON Notary Public • State of Florida Commission x GG 214365 }c d my Comm. Expires Jun 9, 2622 f Banded through National Notary Assn. PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION Mango. 0 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR — Change of Contractor is to be sighed 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 commencing any work. There is a $50.00 fee for the Change of Contractor. X 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 S50.00 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: 2/8/2021 Permit Number: 2010-0277 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Arlington Electric Inc. State License EC:13007767 SLC License 3W4O Original GC, subcontractor or owner/builder Blyco Electric, LLC New GC, subcontractor Reason for Cancellation License EC13001240 SLC License 31779 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 anse as a result of this change of contractor subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed. 51GNATURE:OFOWNER (prow alder) SIGNATURE 0ENE:RA♦wC )NTRACTOR (or new CC, as applicable) PRINT NAME � �a PRINTFtKQQ Ile, State of Florida, County o, . - y The following instrument was acknowledged berbre me this day or 21a 1, by i who is personally known to me or who has p uced as 16 a V812021 Signature or Notary Date Revised 44f15,et5 ,�aiv'a JODI L PETERSON r. Wary Public - State offiorida Commission I GG o72280 My Comm. Expires Feb 12, 2021 MOF,`ti Bandedr,m*NatimalNo" Assn. State of Florida, County of St. Lucie County lowing i s ac ged before me this \lTt.�ititay al' , ? by who��, nally.kunstin.do me o- who has nroduced ___ as ID r Signature orN ry',.„64 921%, hill A.01X0N Notary Public • State of Florida N,, Commission 0 GG 214365 My Comm, Expires Jurt 9, 2022 Bonded through National Notary Assn. PLANNING & DEVELOPMENT SERVICES - = BUILDING & ZONING DIVISION # 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT 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 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to commencing any work. There Is a $50.00 fee for the Change of Contractor. x CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor. The new subcontractor must flit 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 silted and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: 2/8/2021 Permit Number: 2010-0279 Site Address: 9563 S. Ocean Drive, Jensen Beach 34957 Arlington Electric, Inc. State License EC13007767 SLC License 30840 Original GC, subcontractor or ownerlbuilder Slyco Electric, LLC State License EC13001240 SLC License 31779 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 cancellation of permit. A permit cannot be cancelled if work rk has been performed. SIGNATURE OFON'NER(urownrr� uilder' j SIGNATUREGENERIAIL �^NfRACT/OR(ornewGC, asapplimble) PRFMT NAh!£�b``"' -' PRIivTNAAI iUCL, t 1 . � �,.r _ I � State of Florida, County oF>ti --t�i`State of Flonda. County of St, Lucie County The following instrtunent was acknowlL•dged before the this day of Wes. , 20,1, by S W� _ who is personally known to me who hm �t[t ed as ID 218/2021 S 9—Mure of eNotary Date 1?euisa 0�/15/l0' oi+R� ''''• JODI L PETERSON Notary Public -State of Florida ' Commission / GG 072280 My Comm. Expires Feb 12, 2021 ?OPF` gondcdthroL*Nat=NotayAsm wing itu ac lodged before me this doy of � by — Me— tf who ts n mLE.who has p, Md.ed—T as ID. Signature of Notir RIE A. DIXON Notary Public State of Florida f : ; ; Commission p GG 21434S nd ky Comm, Expires Jun 9, 2022 a0rdrd through National Notary Assn.