HomeMy WebLinkAboutchange of contractorPERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
�. Building & Code Compliance Division
• Bt FLDIING PERMIT
SUB -CONTRACTOR AGREEMENT
EHMAN ELECTRICAL CONTRACTOR
(Company ;ilameilndividual lame)
the ELECTRICAL
(Type of Trade)
have agreed to be
Sub -contractor for A GREAT HOME, LLC
(Primary Contractor)
For the project located at 8036 SPENDTHRIFT DR
(Project Street Address or Property'ras 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 advisedpursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR SI61NATURE (Qualifier)
DARRICK BAILEY
I'ItW \`A F
COUNTY CERTIFICATION SUNIRM
State of Florida, County' of ST LUCIE
The foregoing instrument was signed before me this 4 day of
SEPT 20 23, by DARRICK BAILEY
wbo is personally known +� or has produced a
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%tgantyF of NotM Ptfblic
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Print Nsme}oftiotary Puhlir
4e Notary Public Stets of Fioilda
Crystal E Naylon
t . My Commission GG 929549
Expires 1110612023
Fill 04
Revised t 1Ii6 2[
SE'I3 Col,"r OR SICVATf'RE (Qualifier)
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PRINT NAME
V-11,14
COUNTY C FICCIFICATION \tAIRER
State of Florida, County of ST LUCIE
I'hc foregoing instrument was si toed before me this 4 day of
SEPT �, by 'ems LA -ON vo-n
who is personally known Var has produced h
as ideniiticatfon. �y
STAN1P
S na Af Notan Public
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PLANNING & DEVELOPMENT SERVICES
�- BUILDING & ZONING DIVISION
s
2300 VIIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
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 trust 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 Ss0.00 fee for the Change of Sub -
Contractor.
au-M 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: 9/4)2021
Site Address: 8036 SPENDTHRIFT DR
Bellwether Electric
Original GC, subcontractor or owner/builder
EHMAN ELECTRICAL CONTRACTOR
New GC. subcontractor
Reason far Cancellation
CALANDAR ISSUES
Permit Number:
2101-0612
State License SLC License
License��`�SLC License 5�'3
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 n ay arise a result ofthis change of
con€ractorisubcontractor or cancellation of permit. A permit cannot be cancels ork een 507
SIGNATURE OF OWNER (or owier/builder) SIGNATURE GENt L CON'I RACT(:r- GC, as applicable)
PRINT NAME PRINT NANIF_
State of Florida, County of St_ Lucie County
t'he f iling instrument eas acknowledpA before we this
of ,_ 20 21 . tn, - r-liCk
who i gersonzilly kna�i'n to m
ter
d«ha has p uc as CD-
91412021
Sig Lure of Notary Date
Revised 04/?5l1
Ri
y Public Stale of Florida
tat E Nayionommission GG 929549
es 11/W2023
State t) I=lorida_ Cotaity of St. Lucie CountN-
i1 r o11mung in- invent tiros acknowledged before ire this
I day of��-2(Y�, by
t+hc is personally kronor is
orNvho as p uee as ID.
1412021
Si are or \trtaxT Ditte
Notary Pttbiia Slate of Florida
Crystal E Naylor
My Commission GG 929549
Expires 1110612023