HomeMy WebLinkAboutChange of Subcontractor- Electrical Bldgs A-F- - - — PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
COUNTY
2300 VIRGINIA AVE
- FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTM SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASE SELECT ONE -OF THE FOLLOWING:
CHANGE OF CONTRACTOR— Change of Contractor is to be signed and notarized 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 and signature" A new Notice of Commencement must be filed in the new contractor's name
for job values greater than 52,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There Is no fee for
cancellation of the permit.
Date: 2 /2021 Permit Number:
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
2010-0252
Arlington Electric, Inc. State License EC13007767 SLC License 30840
Original GC, subcontractor or owneribuilder
Biyco Electric, LLC Stale License EC13001240 SLC License 31779
New GC, subcontractor
Reason ror Cancellation
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 a result of this change of
contracts contractor or cancellation of permit. A permit cannot be cancefl if work f been Performed.
S1GNA rURE OF OWNER (or otvnerbudder) SIGNATURF. GEN -.RA . CONTRACTOR (ornew GC, as applicable)
PRINT NANF,, J [' ?a _--� PRIM VANE
State of Florida, County OHWAAW",;ra" State of Florida. County of St, Lucie County
The following insaument was acknowledged belbre me this
day of . , 20. by_13..
ykpC1 _ who is personally kno%%m to me
�nrlqs produced— as 10. � ...`
j# { 2/812021
Signature of Notary Date
Revised 04/15/16 JODI L PETERSON
lli s Wary Public - Stateolflorida
Commission t GG 072280
My Comm. Expires Feb 12, 2021
Mf Ilowing" t Ln!was acknowleel ed m ethic
y of I by
wha is m-rsonally known to -
�� who has pro cluced - .!nL.. --as[D. r
~ Signature of
r }i ► + ti
—'BONNIE A. DIXON
Roca
+P; i 1
ry
Notary Public • State of
Q?
Commttslon 9 GG 2' 4365
t' ,Pt
My Comm. Expires Jun 9, 2022
Bonded through Nation'. Notary Assn.
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERINIT
PLEASE SELECT ONE OC THE FOLLOWING:
CHANGE OF CONTRACTOR- Change of Contractor is to be signed and notarized 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 and signature. A new Notice of Commencement must be Filed in the new contractor's name
for job values greater than $2,500 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a S50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PEILNUT — The cancellation of a permit is acceptable only if no work has been done_
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 2f8/2021
Permit Number: 2010.0267
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
Arlington Electric, Inc. State License EC13007767 SLC License 30840
Original GC, subcontractor or ownerlbuilder
Blyco Electric, LLC State License EC13001240 SLC License 31779
New GC, subcontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractorr'sub ontractor or cancellation of permit. A permit cannot be cancelled If rv)Rric has been performed.
SIGNATURE OFOWNFR er ornwner.'buil a —� { d) SIGNATURE GFN�GRnAL e010 RaCTO/R {urnew GC, as applicable)
PPENT NAME ,�_ i PRlv1 VA1IE / Cf't'r�ft�� �L�li��
State of Florida, County ofaty
The rollowtng instrument was acknowledged before me tins
�tay of QA-,� 2Oa-1 , byav 9
_who is Cxrson_alty known to me
or who has ppadmyd as lD
��tiL.��� 218/2021
Signature of Votary Date
Pevssed OVIV ;•; .P'"•,,
JODI L PETERSON
Public - Stateaf flotida
. ;
z�i�ov� ,••'
Notary
Commission i GG 072280
My Comm. Expires Feb 12, 2021
gan&dthMghnahWalWaryAoo.
State of Florida, County orSt Lucie County
wing m I. acknowledged before me this
�} ro�f�Z'-D�-$y
f vi. r Lin I -r/Wno.is_aersonally known to
-m• r Who has anximed e-. ' -tee as ID
of ME A. DWON
notary Public • State of Florida
t yzT Commisslon N GG 214365
?c M1 My Comm. Expires Jun 9, 2022
Bonded through National Notary Assn.
-- - - PLANNING & DEVELOPMENT SERVICES
-I = BUILDING & ZONING DIVISION
2300 VIRGENIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR —Change of Contractor is to be signed and notarized 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 and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
x CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERIMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 218/2021
Permit Number: 2010.0271
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
Arlington Electric, Inc. State License EC13007767 SLC License 30840
Original GC, subcontractor or owner/builder
13lyco Electric, LLC State License EC13001240 SLC License 31779
New GC, subcontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractorsubcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed.
SiGNATt'RLOI-'OWNCR(orowner.bultder) SIGNATURFGENI i. CPF4TRACTOR(ornewciC,asapplicable)
PRINT NADIR- . 1-w:3 PRINTNA,NIE
4� Jam.
State of Florida, County oF$t.awar{ougty
The following instrument was acknawlalged before me this
day o r 1:Z—b • 20_�_L, by ��
-L7{{ who is perwnally known to me
or who has iproctuced as ID
r 202021
Signature of,Notary Date
,e•�„p. JOOI L PETERSON
Revised :�4,'1-!tG � ¢1Notary Public -State of Florida
•. Commission#GG072280
+; My Comm. Expires Feb12,2021
aOp IlWdedthIC4hatiaulNotaryMp,
State of Florida, County of St. Lucie Count}
" In r t was,u aged before me this
Y
L P I 'Aho i_s0rr 0211Y known
who has produced ID.
f
5tgnatureof,'�otE.:
i Na i ubll[ State of Flcrida
Cranmisslon A GG 214365
My Comm. Expires Jun 4, 2022
ded through National Notary Assn
PLANNING & DEVELOPMENT SERVICES
''- - BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE -OF CONTRACTOR, SUBCON"I'RACTOR OR CANCELLATION OF PERUNIT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR— Change of Contractor is to be signed and notarized 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 and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 (57,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There Is a S50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 2/812021
Permit Number. 2010.0274
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
Arlington Electric. Inc. State License EC13007767 SLC License 30840
Original GC, subcontractor or ownerfbuiider
Blyco Electric LLC State License EC13001240 SLC License 31779
New GC, subcontractor
Reason for Cancellation
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 a result of this change of
contractor 'sub ontractor or cancellation of permit. A permit cannot be cancelled if work has been performed.
SIGN,\TURE:OFOWNER(or nwnevlsuilder) SIGN:%TUREGIERALC0 TRACTOR(ornewGC,asapplicabkc)
PRINT NAYS Srt_ t 4:,; PRINT NAUkIE
State o f Flonda. Coutny of =2� _
The following instnumrit was acknowledged before me this
_J day of-RU.. _. , 200�, by_3kg�-,,
who is personally known to me
or who has produced as ID.
��� 2/8/2021
Signature of Nolary Date
Revised 04{15IS'a �'� 1° ''= JOINLPETEASON
Notarypuhiic-state of Fl]2021
• ; Commission t GG o122
=;hy My Comm. Expires Feb 12,amdedlhmghNatkmWNota
State of Flonda, County of St Lucie County
Yo f I !� 'c o bbYgczi before me this
lUI — t L) itb �ytpcmga !X known - to
�nr-whio has produced as ID.
C, 20
Signature of Y' . AIE A. DIXON
Notary Public • State of Florida
4} Y
Y'rcr
Commission x GG 214365
n
my Comm. Expires Jun 9, 2622
Banded through National Notary Assn.
PLANNING & DEVELOPMENT SERVICES
" = - BUILDING & ZONING DIVISION
° 2300 VIRGINIA AVE
^ter FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASE SELECT ONE OF THE FOLLOWING.'
CHANGE OF CONTRACTOR — Change of Contractor is to be sighed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 2/8/2021 Permit Number: 2010-0277
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
Arlington Electric Inc State License EC:13007767 SLC License 3W4O
Original GC, subcontractor or owner/builder
Blyco Electric, LI-C:
New GC, subcontractor
Reason for Cancellation
License EC13001240 SLC License 31779
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 anse as a result of this change of
contractor subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed.
J }
51GNATURE:OFOWNER (prow tlder) SIGNA-rt)RE 0ENE:RACC 1NTRACTOR (or new CC, as applicable)
PRINT NAME ��• � PRINTNAXIttKQQ
State of Florida, County or L��y
The following instrument was acknowledged berbre me this
--dayor,;iA� 21a ,bY�
t who is personally known to me
or who has p uced as ID,
{ V812021
Signature or Notary D21e
Revised 04/1.Vt a �aiv'a JODI L PETERSON
r. Wary Public - State offiorida
Commission I GG 072280
My Comm. Expires Feb 12, 2021
MOF,`ti Bandedr,m*NatimalNa"Assn.
State of Florida, County of St. Lucie County
lowing i s ac ged before me this
\lTt.i titay of-trt , ? by
who��, nally.knnstin.do
.,rne..ib; who has produced ---2 as tD r
Signature orN _ ry��,.�4
DaAbNNlEA.WON
�1f
Notary Public • State of Florida
Commission 0 GG 214365
e
My Comm, Expires Jurt 9, 2022
3onded through National Notary Assn.
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMIT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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 and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 (S7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There Is a $50.00 fee for the Change of Contractor.
x CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must flit out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be silted and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 2/812021
Permit Number: 2010-0279
Site Address: 9563 S. Ocean Drive, Jensen Beach 34957
Arlington Electric, Inc. State License EC13007767 SLC License 30840
Original GC, subcontractor or ownerlbuilder
Slyco Electric, LLC State License EC13001240 SLC License 31779
New GC, subcontractor
Reason for Cancellation
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 a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if work
rk has been performed.
SIGNATURE OFON'NER (uruwneFbuiiderl SIGNATURE GENERAL NfRACTOR tornew GC, as applimblel
PRFHT NAME_: - PRINT NAAI
State of Florida, County o t.uFi<> cyoty State of Florida. County of St, Lucie County
The following instnunent was acknowlL•dged before the thts
�daky of UJ�. ,'� , by 1J�
' elf' who is personally known to me
Who ha tiro ed as ID
202021
S gnature of :Notary Date
Reuisee! 04/13/16 o�+R� 1tx11LPETER50N
Notary Public -State of Florida
' Commission a GG 072280
My Comm. Expires Feb 12, 2021
?OPF` BwdedthroL*NatmlWary Assa
wing itu ac lodged before me this
doy of by
-
Moe- C
n %r mwho has pLmiuced_T as ID. ,, .
Signature of lvota
IRMAIE A. DIXON
Notary public State of Florida
f :
Commission p GG 21434S
n
Yy Comm, Expires Jun 9, 2022
a0rdrd
through National Notary Assn.