HomeMy WebLinkAboutCHANGE OF SUB-AC1• tait�
li Fort Pierce, FL 34982
7(77�2)04
t r i t r
it Virginia Ave.
1 r;a el r ,r � t t r.• r
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 riled 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.
19ate: 11/10/21
Permit hdumber: 2101.0331
Alr Conditioning Unlimited State License GAC1898588 SLC LiCenSe 20.28038
Original General Contractor (or Subcontractor)
Nisair Air Conditioning State License CAC041199 SLC License 10363
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
agents, and employees from all costs, fees, or damages arising from any and all claims of action for
any reason, which may arise result of this change of contractor/subcontractor or cancellation of
a
permit. Ape at not b nee d if ®vork has been perf" e
ION OF RE OF OWNEI or owner/builder) ° sIONA OF NEt 0r� RAL CONTRACTOR
PRINT NAME ry _ PRINTNAW PRICY NISA A
ty
State of Florida, County of St. Lucie County
t
i produced+� . I
t.
whois personally know to me
or he has
Signature of Notary
State of Florida, Coun
of St. Lucie County
The following instnmteat was actmowledged before me this
day of NOVEM8ER.20�t by PHILIP NISAdR
tV I1BIl to e>,C
or 0h0
8
roduc as
Si sturoofNotary Hate k f Id
of subcontractorLa
,KRISIN BITSH0LTSState ofFlorid-NotaryPUUIicCommissionitGG 278527
My Commission Expires
February 19, 2023