HomeMy WebLinkAboutchange of contractorPlanning & Development Services
- d Building & Code Regulations Division
COUNTY 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: 12.22.2021
Site Address' 3937 Shoreside Drive
Meeks Plumbing
Original General Contractor (or Subcontractor)
Permit Number: I�/ "y 5L
State License
SLC License 18623
Master Plumbing State License CFC1428579 SLC License 27366
New General Contractor (or Subcontractor)
Reason for Change Not able to do the job
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.
`PT NAME
NER or or���r
RINT)
State
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of , 20_, by
who is personally know to me
or who has produced as ID.
,4�
SIGNATURE OF NEW GENERAL CONTR PRINTNAME (TL��y K
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of , 20_, by
who is personally know to me
or who has produced as 1D.
Signature gt c •.., FWNCES DONZA Signature o P� ICES DONZA
..., ''fir'
MY COMMISSION # HH 111471 ?*: MY COMMISSION # HH 111471
Po EXPIRES: July 27, 2025
*Only +. Qe relit KSzJul it20 i tang of subcontrac
or a�4; Bonded Thru Notary Public underwriters Bonded Thru Notary Public Underwriters
Revised
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
mpany Name/Individual Nam
the Sub -contractor for
(Type of Trad /
For the project located at C
(Project Street
or Property Tax ID #)
have agreed to
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
K/
Uur rxA(:l'OR SIGNATURE Quaff r)/
PRINT NAME
COUNTY CERTIFICATIO;Z;E Rv
State of Florida, County of
The foregoing in trumentt was signed f re we this ,p day of
20, by
who is personally known _or has produced a
as identiflcadu
-/-
STAMP
Signature of Notary Public
,f/&S x174
lnt Name of Notary 1 FRANCE DONIA
vvu'
MY COMMlSS10N # H 2O25
a oa EXPIRES: July 27,
pubficUnderv+dters
"re az�4Q' Bonded Thru NoW
Revised 11/16/2016
PRINT NAME
273 C�� �GI�z�Ts79
COUNTY CERTIFICAMO UMH§R
State of Florida, County of A Ai+
)hefloregol giustrume.t was slg d before met s 0( J day of
v ' �201�, by
V
who is personally known or has produced a
as identification.
STAMP
Signature of Notary Pu c
Print Na ti RubUc
MY COMMISSI # HH 111471
Po EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters