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: a[al 2 Z
Permit Number:
Site Address: %%�02 I b�SCCA'z
APPEX ELECTRIC
Original General Contractor (or Subcontractor)
JGE II INC
New General Contractor (or Subcontractor)
Reason fox Change Poor Performance
EC13009343 SLC License
License
ER13U15398 SLC Llcense 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 Uesult of this change of contractor/subcontractor or cancellation of
permit. A permi�iann e 5oucBlled if work has been performed.
Rtil'uLW
State of Florida, County of St. Lucie County
The following inrstru fm_ent was aelmowledged efare me this
p�p� day of I�L�J ' 2Q�.by ♦d"i�
nlN4 Cc ,kV who fN a�n..knnwtnme
�o has produced as ID.
v�wignature of Notary Date
°S10NATU `OP NEWG RAL CONTRACTOR
JOHN OAZDACKO
State of Florida, County of St. Lucie County
The following instumenf was ecknowledgGd before me this
day of 20V,,4y JT._�� _.
who
or has produced as ID.
iv
Signature of Notary Date
*only Si u.`quire NMI ubcontractor
•« MY COMMISSION#GGER
Revised 07/21 �e.'oc' 203869
•••`F`OP'� Bonded ThNRNJune 11, 2022
ry Publb Undetwdters
_'�`'•P`•`9t;: SHANNCNMITRER
MY COMMISSION # GG 203869
ep�°' EXPIRES: June 11, 2022
"• Bontled Thru Notary Pobllc Unde�Wdfero
PERMIT# /OFT -O j%(p ISSUE DATE
Co2111��)%.
L L U ki U
f�T
(Type
For the project located at
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUS -CONTRACTOR AGREEMENT
GeG�d have agreed to be
Sub -contractor for —(�DL ra_ �f +li(5
(Prunary contracto ))-{
or Property Tax ID #)
It is understood that, if theze 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,S,ubl ontractor notice.
COUNTY CIS RTIFICNitiONNIZMER
11 i
State of Florida, County ofJ__<<Q.
The foregoing instrument was signed beef -ore me thhis. day of
who is personally Imown or has produced a
Revised Il/1G/2016
SIDS-CONT"CTOR SIGAATURE (Qualifier)
Jflk4j
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PRINT NAAM
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COUNTY C);RTIISCATIONCNUMBt;R
State of Florida, County of,
The[�foreegoing instrumentwas signed before Ld,,me this ay of
' `ob .zo"Z hypo .1, k,
who is personally}5ppyln_. or has produced a
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