HomeMy WebLinkAboutChange of contractor-SUB, ELECTRIC��
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Ch[ANGE OF CONTRACTO
ASE SELECT ONE OF THE FO
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CHANGE OF CONTRACTOR —Change of Contractor is to be signed
and the new contractor of record for the carte � and notarized by the property owner,
nt permit. A new pernut application must also be completed with new
contractor information and signature. A new Notice of Commencement must be
for job values greater than $2 S00 7 5 filed in the new contractor's name
. ($ 00 if A/C Change -out). A recorded copy must be submitted
commencing any work. There is a $50.00 fee for the Change of Contractor. prior to
X CHAItiTGE OF SUBCONTRACTOR —Subcontractor char es are to b
The new subcontractor must fill out a Subco g e completed by the general contractor.
retractor Agreement Form. There is a $50.00 fee for the Chan a of Sub-
contractor. g
CANCELLATION OF PERMIT —The cancellation of a ernut is acce t
Cancellation of perriit is to be si ed and n t p p able only if no work has been done.
gn o arized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 3�16/2021
Site Address: �'� �
M C�ir iA=i-Nn l �
Original GC, subcontractor or ownerlbuilder
f
Permit Number: SLC-2007-0528
State License GIJO�7GLI�13SLC License
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�o�k C)e.�h�c , 1 as�..4�� Cry: �
State T
Ne��v GC, subcontractor
Reason for Cancellation Original Subcontractor could not finish
tense 1GC `��'7,c7S5LC� License
work due to losing staff for Covid-19.
The undersigned does hereby agree to indemnify and hold harmless St Lucie Coun
costs, fees or damages ansing from any and all claims of acti ty� its officers, agents and employees from all
on for any reason, which may anse as a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be ncelled i ork ha
�' s been performed.
SIGNATURE OF OWNER (or owner/builder)
PRIN1^ NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of 2p b
> Y
or who has produced
Signature of Notary
Revised 04/15/16
who is personally known to me
as ID.
3/16/2021
Date
SIGNATURE
PRINT N
CO
OR (or n
GC, as applicable)
State of Florida, County of Q�Q��
The ollo�ving instrument was acknowledge before me this
day of � 20�� by
who is personally known r_n
---�
o has produced as ID.
�1 3/16/2021
Signature of Notary
Date
Kimberly D. PorceMi
NOTARY PUBLtC
STATE OF FLORIt�A
Cortut� GG357446
F�cpires 7/��023