HomeMy WebLinkAboutChange of Contractor46
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pieree, FL 34982
(772)462-1553 Fax 462-1578
RECEIVED JUL 2 2 2015 CHANGE OF CONTRACTOR
Or subcontractor or cancellation of permit
Change of Contractor is to be completed 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,
signature, and transfer fee. A new Notice of commencement must be filed in the new contractor's
name for job value's greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be
submitted prior to commencing any work. Subcontractor changes can be completed by the general
contractor. Any cancellation of permit must be executed by the owner or qualifier of record.
Date: M Ily /Z- 2 o l) Permit Number: 5'L /2 // - c>
f
Site Address:!P/ S A V
410 i' I State License SLC License
Original General Contractor (or Subcontractor)
1-10 h � 1 21 Z zo 766 L L State License Cae-06&,-,3&SLC License Z 31 3�r .
New General Contractor (or Subcontractor)
Reason for Change
The undersigned does hereby agree to indemnify and hold It St. Lucie County, its officers,
agents, and emplo s from all costs, fees, or damages arising from any and all claims of action for
any reason, w ay arise as a result of this change of contractor/subcontractor or cancellation of
permit. F
F
t
(or owner/b 'lder) SIGNA O�GENE ONTRACTOR
of Florida, County of St. Lucie County
The following TPUnent was acknowledged before me this
.L day of J .1 206_- by J v rJ
� d1 r � � vt who is personally Inowto me
or who has produced kAmwn as ID.
S]gnature of Notary Date 6-1) -&/ /5'
State of Florida; County of St. Lucie County
The following instrument was ackmowledged before me this
70 day of [ 20 _L by j2k^ Qf
who is personally know to me
or w _ d FL- $ li as ID.
* change of subcontractor
DAINA S RIZZOTTO
s•i i• MY COMMISSION#FF150377
�;+e►'e;;a�'• EXPIRES August 13, 2018
409 391.0153 Floridallotary/S,
jeryice.com �/
"f /0 �_11311
Date
t 0, EIDUAft 1. TAPIA
s Notary Public, State of Florida
Commission# FF 140697
My comm. expires July 26, 2018