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HomeMy WebLinkAboutchange of contractor (2)Planning & 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: 3902 Duneside Drive Meeks Plumbing Original General Contractor (or Subcontractor) Permit Number: 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. SIGNATUREq �4—x r M/ F WNER`or owneidNrT W L C 0 ] PRIle rTORPRINTNAMEr State of Florida, County of St. Lucie County The following instrument was acknowledged before me this day of , 20, by or who has produced who is personally know to me as ID. Signature of Notary Date FRANCES DONZA i naMY�ulNflld1111 hange EXPIRES: July 27, 2025 Re 3 p ; #V,�&d Thru Notary Public Underwriters 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. Sig�UC�,silt�oJary FRANC NZA ;.. MY COMMISSION # HH 111471 of subco rF oP : EXPIRES: July27.2025 P,"�,,; Bonded Thru Notary Public Underwriters PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT ompany Name/Individual Ndme) the (Type of Trade For the project located at (Project Street have agreed to be Sub -contractor for 194 ( imary Contractor) or Property Tax ID #) 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. C/ COIYrKACTOR SIGNATURE (Qualifier) a �� NAME &'d't - l��a 3g�t COUNTY CERTIFICATION aNUER State of Florida, County of The f egoing i trument was signed before me this Z day of • Zq, by who is personally known _or has produced a as identification. STAMP Signature of Notary Pu is 4>ve!�eIS Print Name of Notary P FRANCE OONZA ti�rivou. MY COMMISSION # HH 11147 Jul 27, 2025 =•: EXPIRES. Y Notary Public Underwriters B "''rFOPF�gQ� onded Thru Revised 11/16/2016 PRINT NAME Z%3 C�� GAG z�s7 COUNTY CERTIFICATION NKER State of Florida, County of—," _ AX-14-� The foregoing Instrument was signed before me thi AA __ day of 202/ by e` ' who is personally known _or has produced a as identification. STAMP Signature of Notary Public 1 Print MY COMMISSION # HH 111471 EXPIRES: July 27, 2025 Bonded Thru Notary Public Underwriters