HomeMy WebLinkAboutChange of Contractor PLANNING&DEVELOPMENT SERVICES RECEIVED
BUILDING&ZONING DIVISION MAY 17 1011
=� _: 2300 VIRGINIA AVE
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FORT PIERCE,FL 34982 PerSti�Lucie Countyent
(772)462-1553 FAX 462-1578
CHANGE OF CONTRACTOR a SUBCONTRACTOR OR CANCELLATION OF PERMT
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 ,fob values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to
commencing any work.'Where 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-
Contractor.
,' n 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 pennit-
Date: 05/13/2021 Permit Number: 2009-0365
Site Address: T175 South US 1 Port St_Lucie,FL 34951
Benjamin Franklin P(umbing State License CFC143o437 SLC License
Original GC,subcontractor or owner/builder
Nortlteastem Plumbing&Drain Cleaning,LLC State License CFC1428759 SLC License
New GC,subcontractor
Reason for Cancellation Work product not to code or approved drawings.
The undersigned does hereby agree to indemnify and hold harm it ss 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
c ctorfstt c llation of permit.A permit cannot be cancelled if work bas been performs
S ATURE OF O (or ownerPouilder) SIGNATURE GENERAL CONTRACTOR(or near GC,as applicable)
PRINT HAMS )A PRINT NAME Eamon Walsh
State of Florida,County of-Se= ieeounty State of Florida,Canty of St.Lucie County
The(following instrument was actamwledged beforre me,this The following instrument was acknowledged before me this
1 `day of 200,by, � day of G:`._ 2pTF
i A ', 31�i�whe is personally known to me 2 jr'' who is personally known to
or has produced L L-^ as ID. me or who has prodh_red-rg,.�=i����. as 1D.
05/13/2021 \4veelftBfrpT
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Signatw pia ry Date �{`mil(02 r";-, `� J Signature omatary Date `ems\tlQ�•..... 9®,''
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(AURA M.001ERON my O A 2021 s
pumc-State of Florida • AUg�st G3,384
• •�``,�Notary � GG 13..
A• •1 Comrrtission 0 GG 363347 09
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PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
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BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
Northeastern Plumbing &Drain Cleaning, LLC. have agreed to be
(Company Name/Individual Name)
the Plumbing Sub-contractor for Eamon Walsh,Construction, Inc.
(Type of Trade) (Primary Contractor)
For the project located at 7175 South US 1 Port St Lucie, FL 34951 3422-211-0010-000-6
(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.
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CONTRACTOR SIGNATURE(Qualifier) /CONTRACTOR SIGNAT (Qualifier)
Eamon Walsh 4ewl AJ GrYPVl/"
PRINT NAME PRINT NAME
CBC1251343 CFC1428759
COUNTY CERTIFICATION
�NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of1 ✓S State of Florida,County ot • 1►�1 C\e
The foregoing instrument was signed before me this day of The foregoing instrument was signed before me this R_day of
20�1 by m 20a�,by �sa��'`►�
who is personally known_or has produced a i�r i'ur_�. who is personally known_or has produced a �U L
as identification. as identification.
\ STAMP STAMP
Signature of Notary
Public Sign,(atture of Notary Pub'
Print N— srM of Notary Public Print Name of Notary Public
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P .IQ,QO i,�� E
°�qG DEANNA GIVENS
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p �'92 Notary?ublicState of Florida P.` Commission 0 HH 086359?My Comm.Expires; F`°o-` tAv Comm.expires Jan 28,2025
Revised 11/16/2016 v i August 13,2021 Bonde•through National of
Assn,
r No.GG 133942
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