HomeMy WebLinkAboutChange of Sub-Contractor (Plumber) Z5'
PERMIT# 1 O ISSUE DATE �l i
Y;lj,; :;� �r ;1t _ :n PLANNING & DEVELOPMENT SERVICES ,
a� ; - Building & Code Compliance Division
^` BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT J U L 2 � �
ST. Lucie County, Permitting
Mechanical One have agreed to be
(Company Narne/Individual Name)
the Plumbing Sub-contractor for D.R.Horton Inc.
(Type of Trade) I (Primary Contractor)
For the project located at LL rk�& I
(Project Street Address or Property Ta.'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.
CONTRACTOR SIGNATURE(Qualifier) SU TRACT'qR`SIGT4AT1JaE r)
Brian W. Davidson Jason James
PRINT NAME PRINT NAME
CRC1327068 CFC1430061
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of Brevard State of Florida,County of Brevard
The foregoing instrument was signed before me this 28 day of. The foregoing instrument was signed before me this 28 clay or
July ,O21byBrian W. Davidson July ,202`1 by Jason James
V
who is personally iaiown_Vor has produced a who is personally known or has produced a
as identification. as identification.
STAMP t /// ��a^""o STAMP
STAMP
Signature of Notary Public Signature of Notary Public
Dina Parrino Dina Parrino
Print Name of Notary Public Print Name of Notary Public
l':*Y'u'•. DINAPARRINO :i!:'Y4 DINAPARRINO
MY COMMISSION 0 GG 935643
MY COMMISSION#GG 935643
EXPIRES;February 27,2024 ;r �?" EXPIRES;February 27,2024
I;andedThru Notary PubtctJnderxrilers SondodTrauNotaryPublicUndeWW3
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PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION —
2300 VIRGINIA AVER
FORT PIERCE,FL 34982 JUL 2 9 "C"i
(772) 462-1553 FAX 462-1578 ST, Lucie county, Permitting
CHANGE OF CONTRACTOR 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 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-
Contractor.
CANCELLATION OF PERINHT—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.
7/28/21 a W 5 0 �
Date: Permit Number:
Site Address:
Ridgeway Plumbing State License CFC019077 SLC License 30947
Original GC,subcontractor or owner/builder
Mechanical One State License CFC1430061 SLC License 32493
New GC,subcontractor
Reason for Cancellation Vendor Change
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/subcont ctor or gincellation of permit.A permit cannot be cancelled if work has been performed.
SIGNATURE OF OWNER(or owner/builder) S[GNAT GEIVER ON R orn C,asapplicable)
Brian Davidson
PRINT NAME PRINT NAkvIE Jason James
State ofFlorida,County ofSL Lucie County State ofFlorida,County of St.Lucie County
The following instrument was acknowledged before me this The Following instrument was acknowledged before me this
28 day of July 20 21 by Brian Davidson is N day of �� 20_,by .lnecn James
personally known who is personally known to me personally known who is personally known to
or who ha pr�e'd-- as ID. me or es pr dneeil as 1D.
7/28/21 i ! 7/28/21
Signature of Notary Date Signature of Notary Date
*?'•'4 ,: DINAPARRlNO ii7u•. DINAPARRINO
.
MY COMMISSION ik GG 935643 MY COMMISSION lk GG 935643
' EXPIRES:February27,2024 EXPIRES:February 27,2024
SondodThruNobryPubFr Undo nrdtei. S,jndedThuMUryPW&Und.r.it..