HomeMy WebLinkAboutChange of Sub - ElectricPlanning & 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: �I %A012 Permit Number:
Site Address: zlvoi asullse4 31 ✓�
APPEX ELECTRIC State License EC13009343 SLC License
Original General Contractor (or Subcontractor)
JGE II INC State License ER13015398 SLC License 31148
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
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, whic may arise as/Ied
lt of this change of contractorlsubcontractor or cancellation of
permit. A per ca of be caf work has been performed.
OF
PRINT
State of Florida, County of St. Lucie County
ThIfollowing instrrumeut was acknowledged before me this
day of YO� , 2�by���
who is personally know tome
r p has produced as ID.
Signature of Notary Date
"NATOR OI;NEW GEI 3RAL CONTRACTOR
FRINTNAME JOHN GAZDACKO
State of Florida, County of St. Lucie County
SIO
The following instrrument was acknowled ed efore me this y�
_ �_ .day of_ 1_, 2o�y of ,�'�'1w
who is personally know to me
has produced % ��_' as ID. yy
CA l� r —
Signature of Notary Date
*Only signat gs•'Fr t�,j.red gIWNNI RR contractor
MY COMMISSION#GO203869 ;;s''`l"'"�i SNAISSION GO2
MY COMMISSION # GO 203889
Revised o7/u/r =F" ` EXPIRES: June 11,2022 µiyY., EXPIRES: June11,2022
.4s)SIO� Bonded Thru No '�''�o oe"
-- �N�o Ond ors Bonded ThN Nobuy public Undawltaro
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
RUILllING PERMIT
SUB -CONTRACTOR AGREEMENT
have agreed to be
Sub -contractor for
For the project located at �[� O .�1,ctN5L� �►/Gt' . I i�i2�CQ „
0.
re
f� yC%8�—
St
et Address or Property Tax ID #)
It is understood that, if there is any change of status regazding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
�1�20
COUNTY CERTIFICATION NUMBER
State of Florida, County of, 7 e 11
The foregoing instrument was signed before we this 1 day of
who is personally knowo�✓ or Las produced a 11
Revised I1/16/2016
SUB-CONTPACTOR SIGNATURE (Qualifier)
JDkn l�tZd4clLd
PRINT NAAIE
COUNTY CERTIFICATIONvNUMBER
Stxtc of Florida, County of W Z KGI
The foregoing iustrumentwas signed before me this / day of
r-h 424Zby tj2hQ "e oil
who is personally known or has produced a l f _D L.