HomeMy WebLinkAboutChange of Contractor13217337092 D. R. Horton - Melbourne
22:00:40 12-16-2015
10 /11
PLANNING& DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION RECEW0
2300 VIRGINIA AVE AUG 13 2021
FORT PIERCE, FL 34982
(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 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:
7/28/21 Permit Number: 21050821
Site Address: 3300 HOMESTEAD DR
Ridgeway Plumbing
Original GC, subcontractor or owner/builder
Mechanical One
New GC, subcontractor
Reason for Cancellation Vendor Change
License CFC019077 SLC License 30947
License CFC1430061 SLC License 32493
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 cancellation of permit. A permit cannot be cancelled if work has been performed.
c7 /.
SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENER CON 1 RACTOR (o, rr—i¢,w C., as applicable)
PRINT NAME Brian Davidson PRINT NAME Jason James
State of Florida, County of St. Lucie County State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
2a day of July 20 21 , by Brian Davidson
personally known who is personally known to me
or who has pre 7� as D.
/.• �r 7/28121
Signature of Notary Date
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NO
MYCOMMISSION#IGO935"3
EXPIRES: February27, 2024
SondW1hwNotary PLMlcUndetwdlen
The following instrument was acknowledged before me this
sa day of My 20_ by Jason Jamos
personally known who is personally known to
me
orwhefifes pr u. as ID.
,8/21 Signature of Notary Date
:ir+��' • DINAPARRINO
MY COMMISSION q GG 935643
WIRES: February 27, 2024
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13217337092 D. R. Horton — Melbourne 22:01:14 12-16-2015 11 /11
PERMIT # 21050821 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Mechanical One
One
(Company Name/Individual Name)
the Plumbing Sub -contractor for
(Type of Trade)
D.R.Horton Inc.
(Primary Contractor)
For the project located at 3300 Homestead Dr
(Project Street Address or Property Tax ED t0
RECEIVED
AUG 13 2021
St, t erf eti�
have agreed to be
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)
Brian W. Davidson
PRINT NAME
CRC1327068
COUNTY CERTIFICATION NUMBER
State of Florida, County of Brevard
The foregoing instrument was signed before me this -$day of
.1111 Y .202t by Brian W. Davidson
who is personally known_�,/or has produced a
as identification._
STAMP
Signature of Notary Public
Dina Parrno
Print Name of Notary Public
DINAPARRINO
MY coMMISSiON # GG 936U3
rPA EXPIRES; February 27, 2024
:fRfE. rondodTh.NotaryPublkUadeWtars
SUB- TRACT 1 r)
Jason James
PRINT NAME
CFC1430061
COUNTY CERTIFICATION NUMBER
State of Florida, County of Brevard
The foregoing Instrument was signed before me this 28 day of
JULY 2o21 by Jason James
who is personally known v`or has produced a
as identification.
—%-----------
"Iy.�..a--� STAMP
Signature of Notary Public
Dina Parrino
Print Name of Notary Public
DINAPARRIND
MY COMMISSION # GG 935643
+- ; EXPIRES: February 27,2024
! a: r ? •• gonded Thor Notary Public Undannilers