HomeMy WebLinkAboutChange of Contractor 13217337092 D.R,Horton-Melbourne 21:59:58 12-16-2015 8/11
_ PLANNING&DEVELOPMENT SERVICES
BUILDING& ZONING DIVISION
RECEIVED
° 2300 VIRGINIA AVE
FORT PIERCE, FL 34982 AUG 13 2021
(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: 7/28121 Permit Number: 21050789
Site Address: 3336 HOMESTEAD DR
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 cancellation of permit.A permit cannot be cancelled if work has been performed.
SIGNATURE OF OWNER(or owner/builder) SIGNAT GENER ON R orn C,as applicable)
PRINT NAME Brian Davidson PRINT NAME Jason James
State of Florida,County of St Lucie County Stale of Florida,County of St Lucie County
The following instrument was acknowledged before the this The following instrument was acknowledged before me this
28 day of July 20 21 by Brian Davidson _!!_day of Jay 20_,by Jawn Ja
personally known who is personally known tome personally known who is personally known to
or h pa as 1D. me oryvheifns pr u as!D.
7/28/21 ,-0 7/28/21
Signature of Notary Date signature of Notary Date
u+S'`"• DINAPARRIND ii+�"'•, DINAPARRINO
ip
MY COMMISSION tl GG 935643 '
.. .; 'ruary 27,2024 ,. MY COMMISSIONfZGG935643
6onde47twNobDPu6raUade�wdt�rs y ' EXPIRES:February 27,2t124
7 bonded tlwNotary AihCc Undenttlura
13217337092 D.R.Horton—Melbourne 22:00:22 12-16-2015 9/11
PERMIT# 21050789 ISSUE DATE
...J
PLANNING&DEVELOPMENT SERVICES RECEIVED
Building & Code Compliance Division
•
• BUILDING PERMIT AUG 13 2021
SUB-CONTRACTOR AGREEMENT St,Lu®ib CountyI'prfItlne
Mechanical One have agreed to be
(Company Name/Individual Name)
the Plumbing Sub-contractor for D.R.Horton Inc.
(Type of Trade) (Primary Contractor)
For the project located at 3336 Homestead Dr
(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.
CONTRACTOR SIGNATURE(Qualifier) SUB- TRACT I E 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 or Brevard
The foregoing instrument was signed before me this-$day of The foregoing instrument was signed before me this 28 day of
JIII Y ,2021,by Brian W. Davidson JULY 2021by Jason James
who is personally known-or has produced a who is personally known Vor has produced a
as identification. as identification.
STAMP STAMP
Signature of Notary Public Signature of Notary Public
Dina Parrino Dina Parrino
Print Name of Notary Public Print Name of Notary Public
. DINAPARRINO DINAPARRINO
MYCOMMISSION#GG935643 MY COMMISSION#GG935643
a EXPIRES:Febnlary 21,2024 'Al A: EXPIRES:Febmary 27,2024
Bonded 1hN Notary P�Ik Undaiwdt�ro gip.i 4".'' Bonded Thm Notary Publlc Underwritero