HomeMy WebLinkAboutChange of Contractor i
RECEIVED
Planning&Development Services
Building&Code Regulations Division MAR 0 4 2021
2300 Virginia Ave. Permitting Dapartment
Fe3:t:Pierce„FL.3-4982 St. Lucie County
(772)4624553-Fag 4624578
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 ($7,500 if A/C Change-out). A recorded copy must be
submitted prior to commencing any"work. Subcontractor-changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and,qualifier of.record.
Date: 2 1 n Permit Number: 9 IOC...O A 14
Site Address: 'Z �� JUI��$ �(, i'p j. (,l.lG e— F L 3 y9 S
0,0&=61n C, State License SLC Licenseg
Original General Contractor(or Subcontractor
U, ,,Ce_ co-mm'). I �1re State License Ce<e15943ag SLC License
New.General.Contractor.(or Subcontractor).
Reason for Change ( iCI IJ ► P l) C&W--61076�
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 mA ar' e as a result of this change of contractor/subcontractor or cancellation of
pSe cle if work as been performed.
,per
ATUREOFOI (or-o /builder)- ° IGNATURE OF ENERAL CONTRACTOR.
F
PRINT NAME PRINTNAME�W G �5 ae
tK
State of Elimm County of A3-L County State of Florida,County of St Lucie County
The following instrument was acknowledged before me this The following instrument was acknowledged before me this\
day oft Ij 20�I by C. day of 20�� by V u�
CU who is personally know to me who is personally know to me
or who has producedp• 1..i ce�,c'-as 11D who has prod u L as
rgnature of Notary Date EBRA EXANDER Signature of N r'P� D26EANNA GIVENS
NOTARY PUBLIC-STATE OF MICHIGAN o.` e4.
ALPfENA COUNTY Notary Public State of Florida
*Only signature require or c ange of su contract a` Commission 9 HH 086359
of My Comm.Expires Jan 28,2025
Revised o�/zi/i4 My Commission Expires October 18,2021 " Banded through National Notary Assn.