HomeMy WebLinkAboutchange of contractorPlanning & 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: 12.23.2021
Site Address' 8228 S Ocean Drive, Jensen Beach
The Plumbing Company of the Treasure coast
Original General Contractor (or Subcontractor)
Permit Number: 2103-0692
State License
SLC License
Master Plumbing State License 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.
SIGNATURE OF7___,NER(or o� r/bu� er)
PRINTF��"
State of Florida, County of St. Lucie County
rfollowin ' rument w s acknowledged before me this
day>o 2(�4 by
who is personally know to me
or who has produced _ as ID.
Signature of Notary Date
*Only =5I"gna05ta.,jgGc
tii 1 LU^hiv11SSICN # H 2 1_
Revis ci::«tt1Y27.205
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• , •�,, Bonded Thtu Nam'""`�
* SIGNATURE OF NEW GENERAL CONTRACTOR
PRINT
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.
Signature of Notary Date
change of subcontractor "R"""""'r
. •;.�° `•• PRANCES DONZA
PAY COMMISSION # HH 111471
EXPIRES: July 27, 2025
F;'�°• Bonded Thru Notary Public Underwriters
Ldt36 �1 S
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
f have agreed to be
(Company Name/Individual Na#)
the R—(%Irn 0&-, Sub -contractor f� i
(Type of Trade) Primary Contractor)
For the project located at
J'uo' cS ,
(Project Street Address or
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.
'-_
CONTRACTOR SIGNATURE (Qualifier)
PRINT NAME
2S(!� /_5a --�?s9
COUNTY CERTIFICATION MBE
State of Florida, County of
TN foregoing Instrument was signed before me thiday of
21,by
who is personally known —or has produced a
as identification.
STAMP
Signature of Notary Public
Print Name of Notary Pu ^ - - - --
FRANCES DONZA
MY COMMISSION # HH 111471
EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters
Revised 11/16/2016
PRINT NAME
Z% 3 (P(o P�G Jq Z S?-S" 7
COUNTY CERTIFICA ION N ER
State of Florida, County o
Tkw foregoing strument was signed fore me this jViday of
,2by. who is personally know or has produced a
as Identification.
STAMP
Signstu a of Notary Public
Print
FRANCES DONZA
MY COMMISSION # HH Ill471
EXPIRES: July 27, 2025
Bonded Thru Notary Public Underwriters