HomeMy WebLinkAbout20210621_PLANNING &DEVELOPMENT SERVICES Building &Code CompliancPLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
Aqua Dimensions Plumbing
(Company Name/Individual Name)
the Plumbing
(Type of Trade)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for Villadelta Construction Corp. LLC
(Primary Contractor)
For the project located at 2430 Noble Okas Lane, Ft Pierce fL 34981
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
�C RACTOR SIGNATURE (Qualif
ie
r) /
c 0 blJ l
t�0 h n
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of 5 f. ✓ C.i e .
ism
'The foregoing instrument was signed before me this ,;z day of
who is personally known has produced a
as identification.
Signat otar®Public
PrintNa 4'M j��#HH04104
' ,a¢"P`• Expires September 13, 2024
BondedTlruTroyFainhWMWgo, 7019
Reci-tied 11 10 2010
Robert Ludlum
PRINT NAME
18628
COUNTY CERTIFICATION NUMBER
State of Florida, County of .St Lucie
The foregoing instrument was signed before me this 15th day of
June 20_ by Robert Ludlum
who is personally known Y or has produced a
a identification.
STAMP STAMP
Signature of Notary Pu \
Rhonda Lafferty
Print Name of Notary Public
Notary Public state of Fbnda
Rhonda Lafferty
My Commissan 1111094211
45 Expires 0211712025
i
COUNTY
F L O R 1 D A
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
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 ($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.
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 $50r
a 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:
Permit Number: 0210 % - 0 33 %
Site Address: a y 3 0 A o b t e_ Cn b;� 5 kcin-c-,
0 rn 0 State License SLC License
riginal , subcontractor or owner/builder
l) �vl
Q Cc l ✓1 I 0 I State License SLC License
New G , subcontractor
Reason for Cancellation \ ✓ : s �- / li t'� I �(1 �� C.t(,3 ike 6",T-0 r hV
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 caiwellk if work has been performed.
SIGNATURE OF OWNER (or owner/builder) IGN GENERAL CONTRACTOR
hor new as applicable)
PRINT NAME&4?1F4_1M RINTNAME_ 1 /
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
_day of _ 20 k,
7 who is rsonally known to e
or who 1 roduc as ID.
��- ( ,.._.1�1
SSgnatutaf
,)ANAL. BRIDGES
= Commisson # HN 041043
*'mbar 13, 2024
Revised 04/ fGft��P Expires ,ImyFainlnyu"80038�T019
State of Florida, County of St. Lucie County
The fol_]owing instrument was acknowledged before me this
7dayof _ 202� by 0 (J •,cl l��
who ' sonally known to
me or wh as produc as ID.
S*_ Notary Date 6
pM,pY►.'• JANAL.BRIDGES
Commission # NH 041043
;pa Expires September 13, 2024
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