HomeMy WebLinkAboutCHANGE OF CONTRACTOR 11-11-21Planning & Development Services
SI J Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 4624578
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 ($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. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 11/11/21
Site Address: 5305 Hickory Dr
Permit Numbers 210E-0122
Air Condltloning Unlimited State License CAC1818588 SLC License 20-2ao3s
Original General Contractor (or Subcontractor)
Nisalr Air Conditioning
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
License cAC041199 SLC License 10363
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 p it not b /Jnccee�}��{if work has been perfor e .
SI TURB OF 0 (or owner/builder) • SIONA RE OF NEAL CONTRACTOR
AW NER
State of Florida, County of St. Lucie County
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signature
S®M`�ANNONMIit1kR s
p)1(COMMISSION#„�
El(pIRE5: Ju❑0� un>awlt¢
PHILIP NISA
State of Florida, County of St. Lucie Comfy
of subcontractor
""' KRISTIN BAITSHOLTS
&a4 Stale of Florida -Notary Public
Commis aion H GG 278527
My Commission Expires
February 19, 2023