HomeMy WebLinkAboutChange of Contractor1 Planning g & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
' Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
signature, and transfer fee. 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. Subcontractor changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 5/11/16 Permit Number: —C)G —�j [��rj
Site Address: ���{- 'N, L/� f k�G� t.�
Richard Manning Woodley
Original General Contractor (or Subcontractor) State License CBCA17970 SLC License
Scott Harala
New General Contractor (or Subcontractor) State License CGC1506052 SLC License
Reason for Change Richard Woodley left company
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 has been performed.
SIGNATURE OF OWNER or owner/builder)
SIGNATURE OF NEW GENERAL CONTRACTOR
PRINT NAME PRINT NAMEScott Harala
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
' S day of May .20 1a b
Scott Harala y
who is personall know to me
DENISEb
as ID.
,o4�Y.ev.B4-, 607
Jr n rfol s November 4D'_ Bonded Thru Troy Fain Insurance 355-7019
e�
S
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of May 20 16 by
Scott Haraar -whotis personally know to me
or who has produce
DENISE BRAWN
Cb ' ion # FF 140607
Signature of Notary T Expires November 4, 2018
. i... Bonded Thu Troy Fain Insurance 800-385-7079
ignature required for change of subcontractor
Revised 07/21/14