HomeMy WebLinkAboutChange of ContractorM
10/17/2019 09:19AM 7722733081
TRM
PLANNING & DEVELOPMENT S
BUILDING & ZONING DIVISION
2300. VIRGINI.A. AVE
FORT PIERCE, FL 34982
(772). 462-1553 FAX 462-1578
jPAGE 02/03
�IZVIC
RECEIVED
0 C T 212019
ST. Lucie CeunCYl Permlc1 I
CHANGE OF CONTRACTOR• SUBCONTRACTOR OR CANCELLATION OF )PERMT
PLEASE SELECT ONF OF THE FOLLOWING:
MANGE 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 now 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 $50.00 fee for the Change of Sub-
Cootlractor.
CANCELLATION OF PERMJ(T — 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
caneeHation of the permit.
)Date:
October 18, 2019
Permit Number: 1904-0094
Site Address: 131 Ocean Estates Drive, Fort Pierce, FL 34949
Del -Air Heating & Air Conditioning- State License CAC032448 SLC License 27191
Original GC, subcontractor or owner/builder
Dorado Heating & Air Conditioning
New GC, subcontractor
License CAC1819520 SLC License 31188
Reason for Cancellation Change of Subcontractor
The undersigned does hereby agree to indemnify and hold hartgless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for a reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit, A, perxi carllrot cancelled if work has been performed.
SIGNATURE OF OWNER (or ownedbuilder) SIGNAVRBF-,WRAL CONTRACTOR (or new GC, as applicable)
PRINT NAME PRIN� ` 1`lc 4+ �~
State of Florida, County of St, Lucie County State offloads, County of St Lucie County
The ;Following instrument was acknowledged before me this T e folldoawing instr=e t 20 owl ed efore me
9C
_day of , 20� by � y&hi �� r
who is personally known tome who is person known to
or who has produced as IA. me w o has uce as W
Signature of Notary Date Signryature o Date
P.
,..Y•;"A PAUL J PAYNE
Revised 09/15/16 Commisslan * FF 964120
My Commission BxpEeea
1140-Wfebruory 24, 2020