HomeMy WebLinkAboutChange of Sub-Contractor (Plumber) lob
PERMIT# ISSUE DATE
K„ .^s. .z , _ Y PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division RECEIVIED
BUILDING PERMIT 2021
SUB-CONTRACTOR AGREEMENT ,J U L 2 9
ST. Lucie County,Permitting
Mechanical One have agreed to be
(Company Name/Individual Name)
the Plumbitig Sub-contractor for D.R.Horton Inc.
(Type of Trade) Q 2 (Primary Contractor)
For the project located at
(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.
CONTRACCO&SIGNATURE(Qualifier) SUB- TRACT f E t r r)
Brian W. Davidson Jason James
PRINT NAME PRINT NAME
CRC1327068 CFC14300.61
COUNTY CERTIFICATION NUMBER COUNTY CERTIFICATION NUMBER
State of Florida,County of Brevard State of Florida,County of Brevard
The foregoing instrument was signed before ntc this 28 Jay of The foregoing instrument was signed before me this 28 day of
July 2021byBrian W. Davidson July ,02`1 by Jason James
wlio is personalIy lcnown_\/or has produced a who is personally(mown v or has produced a
as identification. as identification.
STAMP �/� ���""^a STAMP
Signature ofNatary Public Signature of Notary Public
Dina Parrino Dina Parrino
Print Name of Notary Public Print Name of Notary Public
iR rYr DINAPARRINO ii9 f`'r�b .. DINAPARRINO
?.. MY COMMISSION MY COMMISSION 0 GG OW3 to GG 935643
o EXPIRES;February 27,2024 ? EXPIRES;February 27,2024
f«�`' SondodfiN Notary Public Undermttars O!'' SondWThru Notary PubliaUndervMtem
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PLANNING &DEVELOPMENT SERVICES
y`= BUILDING& ZONING DIVISION
RE CEIVED
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 J U L 2 9 2021
(772) 462-1.553 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 pennit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be Fled 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
conunencing 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 Forni. There is a$50.00 fee for the Change of Sub-
Contractor.
CANCELLATION OF PERI HT--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: 7128/21 Permit Number: c:;)�0 3 G �l
I'I 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 etor or cancellation of permit.A permit cannot be cancelled if work has been performed.
n�
SIGNATURE OF OWNER(or otvner/builder) SIGNAT GENBR ON R orn C,as applicable)
PRINT NAME Brian Davidson PRINTNAME Jason James
State of Florida,County ofSt.Lucie County State ofFlorida,County ofSt.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 day,of .rub 20_,by �116on J---
personally known who is personally known to me Personally known who is personally known to
or who•ha rs�tri�� �as ID. me or .cr as r dui as ID.
�� �f�L,4, 0 7f28/21 �� ,,-0 7/28121
Signature of Notary Date Signature of Notary Date
Sty%"'• DINAPARRINO .:�%�''•. DINAPARRINO
` MY COMMISSION#GG 9=3 MY COMMISS{ON#GG 9356A3
�T> EXPIRES:FeWuary27.2a24
bo EXPIRES:Fatuuary27,2024
nded'MruWta PubrcUndmwrit.rs
ry ' c.n FandedThnr Notary PubL'cUnderirriters