HomeMy WebLinkAboutCHANGE OF SUB-ACPlanning & Development Services
S J71= 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• ttnolzl
Site Address: 4801 Sunsat Blvd
Air Condltloning Unlimited
Original General Contractor (or Subcontractor)
Nlsair Air Condltloning
New General Contractor (or Subcontractor)
Resson for Change Poor Performance
Permit Number: 27o5-ona
CAC1878588 SLC LICenBe 20.28038
License cncoattss SLC License 10363
The undersigned does hereby agree to indemnifv 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 it c ifnot be 9 elled if work has been perform
me TURF OF OWNER/or owner/builder) SIONAI LCONTRACTOR
State ofFlorida, Couaty of St, Lucie County
The following instrumalit was eclmowled before me thin
1\ aayofVoJ .2tt?-1
-LI
I
PRINT NAME PHILIP NISA JR
Slate of Florida, County of St. Lucie County
insttument wes aclmowledged before me tlils
NOVEMBER.20Ji by FHILIP.N1ahJR�
of Notary Date
change of subcontractor �KRISTIN BAITSHOLTS
�, SHANNON MIT7LER c°€ �'=_State of Florida -Notary Public
yis 4Qymyc0MMISSION#GG203869 ;,®, Commission s GG 278527
a�e EXPIRES: Jura 71, 2022 %,?ol,�a" MY Commission Expires
°' Guided Thru = undermi 8 February 19, 2023