HomeMy WebLinkAboutCHANGE OF SUB-ACPlanning & Development Services
..., .1 c Building & Code Regulations Division
111 2300 Virginia Ave.
Fort Pierce, FL 34982
(772)4624553 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 ($75500 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: 11/11121
Site Address: 5204 Hickory Or
Permit Number: z108-0103
Alr Conditioning Uniimiled State License CAC1918555 SLC License 2azao3e
Original General Contractor (or Subcontractor)
Me& Air Conditioning State License CAC041199 SLC License 10353
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
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 a result of this change of con ctor/subcontractor or cancellation of
permit. Ape it nnot b ace if work has been pier e .
ernvA nu nw (nr SIGNATURE OP NE)4GENERAL CONTRACTOR
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State of Florida, County of St. Luoio Comty
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PHILIP NISA JR
State of Florida, Comty of St. Lucie Comty
e Following iustnuueat was acknowledged before me tins
_day of NOVEMBER 40 eta PHiu°_--"ism
JlgantureotNotary KRISTIN BAITSH
State of Florida-Notar
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