HomeMy WebLinkAboutCHANGE OF SUB-ACPlanning & Development Services
Building &Code Regulations Division
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 ($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: 11/11121
Site Address: S6 Pinewood Lene
AIr Condltloning Unlimited
Original General Contractor (or Subcontractor)
Niselr Air Conditioning
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
Permit Number: zloe•o�1s
Licensecnclelasss SLCLicense zo-2eo3s
License CAC041199 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 a It of this change of contr ctor/subcontractor or cancellation of
permit, A per ca t be c tiled if work has been perfor e .
cTON 1RE OP OWNS (or owner/builder) " SIGNATURE OF NE NERAL CONTRACTOR
State of Florida, County of St. Lucie County
1004%
Signature of Notary Date
PHILIP NISA JR
of St, Lucie County
State ofFlorida, County
�� 11 2� J,IA .� .
r
*On nge of subcontractor KRISTIN BAITSHOLTS
"M.+p,"••., SHANNONMITTLER
;.�"c; '�% s.,State of Florida-No[arY Public
Revi 0 COMMISSION # GG 203869 �ft= Commission # GG 278627
6a/ EXPIRES: June11 2022 c My Commission Expires
�ynoo Bonded Tin Nolery WNbUndenefts February 19, 2023