HomeMy WebLinkAboutCHANGE OF SUB-ACPlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
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 values greater than $2,500 ($79500 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, Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date• 1v1on1
Site Address: 5802 Blrch Or
Alr Conditioning Unlimited
Original General Contractor (or Subcontractor)
Nleair Air Conditioning
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
Permit Number: z1o�-o5e7
License CAC1818688 SLC L1Cel]se 20-28038
License CAC041199 SLC License 70383
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 result of this change of contractor/subcontractor or cancellation of
permit. A per • ccelled if work has been perf "red,
SIGNA OF OwNEtt (or`�o1wner_"/b/uildeer)`` ^. *SIWATUREU F E GENERAL CONTRACTOR
PRINT NAME MU�IU kkCl b FRINTNAw PHILIP NISA A
State ofPlodde, County of St. Lucie County
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61tinsture of Notary Date
State of Florida, County of St Lucie County
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*Only signature c nge of subcontractor KRISTIN BAITShIOLTS
3tWiNONMITIIFR State of Florida -Notary Public
Revi d "J4 4WCOMMISSION #GG203869 y®• Commission # GG 278527
FJ(pIRES:d8�11,2022-,;,�zo, My Commission Expires -
--) �d��,y puNblMdatwtM� February 19, 2023
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