HomeMy WebLinkAboutCHANGE OF CONTRACTORC01V 111115,
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
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: December 8, 2021
Site Address: 9632 Enclave Circle Port Saint Lucie FL 34986
Ed's Electric (SubContractor)
Original General Contractor (or Subcontractor)
S&W Electric (SubContractor)
New General Contractor (or Subcontractor)
Permit Number: 2108-0795
State License EC0001569 SLC License
State License EC13007544 SLC License
Reason for Change Unable to perform work due to death in the family
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 has been performed.
SIGNATURE OWNER r wner/builder)
PRINT NAMETN OM AS M hfR t D>E S
State of Florida., County of St. Lucie County
The foll wing ent was acknowledged before me this
/yCday f 2Q& by�
r RU 1 S who is personally know tom
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of Notary Date
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* SIGNATURE SEW GENERAL CONTRACTORrPRINT N �& K r .O� (�J
State of Florida, County of St. Lucie County
The following instrument was admowledged before me this j }"dayof�2021by D6,111d,TUUS
who is personally know to me
or wV has producedg y rt as ID.
t
Signature o otary Date
*Only signature required for change of subcontractor
Revised 07/21/14
KAREN MIRET
Commission $ GG 346204
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Expires October 18. 2023
or f`�PO
Bated Ttw Bud�M Pbl.ry Swvlc�t
NN� Notary Public State of Florida
Ginger P Hester
y My Commission GG 330259
'=yap Expires08125/2023