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HomeMy WebLinkAboutchange of contractor (2)PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION !COUNTY 2300 VIRGINIA AVE FORT PIERCE, FL 34952 (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT 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 S50.00 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 gLialifier of record. There is no fee for cancellation of the permit. Date: 9/412021 Site Address: % arc Bellwether Electric Permit Number: 2101-0652 State License SLC License Original GC, subcontractor or owner/builder EHMAN ELECTRICAL CONTRACTOR State License SLC License New GC. subcontractor Reason for Cancellation CAL.ANDAR ISSUES 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/subcontractor or cancellation of A permit cannot be cancelled " c has t!er� per%r SIGNATURE OF OWNER (or oNvner/builder) SIGNATURE GENERAL CONTRACTOR (or now s applicable) PRINT NAME PRFNTNAME State of Florida, County of St. Lucie County The fallmNing instrument was ackno%vledg before one fthis /=daft' ot__,t� �) z 1 ieho i, rsandli� kno Coto me or r teed as ID. 91412021 Si tore of Notary If Date State of Florida, County of St. Lucie Comity Th f 11 iug instrument tips acknu ledg before ine t is da} of ��- nl3o i perSpnally knoFin to n tha h ro ccrl as ID. 9/412021 Sig n_ of Noktry rate P.evised 04/15/16 ADte or Ftor da NEE] ylon n GG 9295�4923 Notary Put?lic State or florida Crystal E N2V1W ` My Commission GG 9295 t8 or nPp �xpites i11w2©23 Vie PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division _ BUILDING PERMIT SUB -CONTRACTOR AGREEMENT EHMAN ELECTRICAL CONTRACTOR have agreed to be (Company Name/Individual Name) the ELECTRICAL Stab -contractor for A GREAT HOME, LLC (Type of Trade) — (Primary Contractor) For the project located at 7828 SADDLEBROOK 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. f� Co TRACTOR SIGN_" RE Qualifier) DARRICK BAILEY PRINT NAME COUNTY CER'I­lFICTTION'\t_MBE:R State of Florida, County of ST LUCIE The foregoing instrument was signed before me this � day or SEPT zdJ by DARRICK BAILEY who is personalty known " nr has produced s as idcnti�cation. i Signature,pTotary Public CW,__&J �,b, (Un Print . me of Notary Public Sl''S•C:ONTR �WSIG RE {Quanlier) PRINT NAME 3 49 COUNTYCERTIFICATION NUMBFR State of Flurida, County of ST LUCIE The foregoing instrument vva% signed berore me this 4 day of SEPT 2o2A, byMl YI_ lCl who is personalty known or has produced a as identification. TSCAMP A slAMP signs rre fN i Public Notary Public Stets of Florida Crystal E Nayion y My Commission GG 929549 �1y p Expires 11/06/2023 Revised 1 ] 1160016i �%Cav to, Wo5ean- . Print Name of Notary Publit mAfu `,O� '1-'AVEK':V - a� � ss MY ComMIS,•' ,N CG SN �XP1R;:S; Ala�ttst 7, y. ,o • ' Bonded Thru NDry F ulNie ! ]ttd/lYtllfe►s