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: C>6 Id l ZZ
Site Address: S 31)5 i� C LL1 U 4
APPEX ELECTRIC
Original General Contractor (or Subcontractor)
JGE II INC
New General Contractor (or Subcontractor)
Reason for Change Poor Performance
Permit Number: OZ��FS-O� ZZ.
EC13009343 �
License SLC License
LleeriSe ER1301539E SLC. LiCenSe 31148
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
i
rmit./perrniann pbe cance edifwork has been performed.
i1�SIGNA (or o'►e^r ilder) 'SIONA7URr, OP NEW GEi RAL CONTRACTOR
PRIN NAME �Dr�IV\(a/� PRINTNAMS JOHN GAZDACKO
County
State of Florida, County of St Lucie County
The following ins`tm 1ment was aclmowledged before me this
day of {2n
.2024by_�(�,r�
L who is personally lmow to an
�wha^ ha,s-pr•oduced as ID.
Signature of Notary Date
State of Florida, County of St. Lucie
The following instrument was aclmowledged before me this
day of 1�0�_ , 2yy by T
(/1 Ci �CttC `1,/ who ispersonally Imow to me
o w has produced as ID.
1 0AM
n
Sig ature of Notary Date
*Only signature required for change of suhcontracto
SHANNCN MITTLER
SHANNON MITTLER ' yI
Re it2I/19 - , MYCOMMISSION#GG203869
MY COMMISSION # GG 203869 `: e� EXPIRES: June 11, 2022
EXPIRES:June11,2022. .l%"PFl3°t' Banded Thru Notary Publ1Undenvr8ers
P�: Bonded Than Notary Public Undenetlers _
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILllING PERMIT
SUB -CONTRACTOR AGREEMENT
(Project Street Address or
have agreed to be
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
filing of a Change of Sub -contractor notice.
CONTRACT SIG ATURE (Qy er)
y��
PRINT NAME
31a.ao
COUNTY CERTIFICATION NUMBER
State of Florida, County of 5 Lt.IQ,O -"
The foregoing instrument was signed before me this c:;L day of
who is personally known or has produced a
STAMP
,�;�J¢;�,� SWANNONMITTIER
MY COMMISSION # GG 203869
'y, EXPIRES: June 11, 2022
Revised 11/16! fg;;o,,44^re Bonded Thm Notary Public Underwlt Au
SUB-CONT1tACTOR SIG'VATURE (Qualifier)
.Jok�t istzd4�Yei
PRBVT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of Lair /
The foregoing instrument was signed before me this day of
wh is pe=n Ii�.ua or has produced a
STAMP
. a�'"'r,.,'��s SWWNON MITi1.ER
MY COMMISSION # GG 203889
EXPIRES: June A2022
Bonded Thru Notary PublicUndenMdtors