HomeMy WebLinkAboutChange of Subcontractor-ElectricPlanning & Development Services
S, - : Ult1i = Building & Code Regulations Division
2300 Virginin Ave.
Fort Pierce, FL 34982
(772)4624553 Fax 4624578
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 $23500 ($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: 12naIz1
Site Address: 4005 AVENUE T ,FORT PIERCE, FL 34947
APPEX ELECTRIC
Original General Contractor (or Subcontractor)
JGE II INC
New General Contractor (or Subcontractor)
Reason
for Change POOR PERFORMANCE
Permit Number: 21os-ozss
LICenSe EC73009343 SLC License
State License ER13015398 SLC License 31t48
The undersigned does hereby agI•ee to indemnif�nd 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, wh117ay arise a result of this change of contractor/subcontractor or cancellation of
�eyrh permit. A p'F1' i�dnnot J aacollled if work has been performed.
Stnlc of Florida, County of St Lucie Counry
The following iaslrumenl was acknowledged Before me 0ris
_duv nf.�.�.2��, by�
�V�Pv4it�.t.� who,is oersonaily know lnmc
�ho has produced .os ID.
'_z1zrl V
Signature of Notary Date
IT
4�
'SIONATUR OF NEWI_GEi RA/L�CONTRACTOR
PRINTNAME w1 L7sZdRCteb
County
to of Florida, County of St. Lucie
Sta
The following inslmmenl nos aeknmvledgedb��efore me 0ris
ZSfday of�iC_ ,2Zk,by—TJ- 6A _
vvbo iyersonally }mmv to mc_
o has produced ID.
Signature of Nanny Date
*Only sigma u^'•°.uireilM��i4Nps�rSR f subcontractor. "�:'"."•• SHANNONMITTLER
MYCOMMISSION
Revised 07/21/ 3�'• 'e' EXPIRE&Jun811,2022 q; s_ MY COMMISSION# GG 20380
„ao•C,f; `C gondetlmNNotery PuNkUndennaras;; '�; EXPIRES: June 11, 2022
�� ,?�:°'• Bonded Thm Notary PuElk Onderwiers