HomeMy WebLinkAboutChange Of ContractorVIE D
E
Planning & Development Services
Building & Code Regulations Division MAY 1 12016
2300 Virginia Ave.
' Fort Pierce, FL 34982 PERMITTING
St. Lucie County, FL
(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: 5/11/16
Permit Number: _ j (�Site Address: IAJ
Richard Manning Woodley
Original General Contractor (or Subcontractor)
Scott Harala
New General Contractor (or Subcontractor)
Reason for Change Richard Woodley left company
State License CBCA17970 SLC License
State License CGC1506052 SLC License
The undersigrPd does hereby agree to mdem i 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 OF OWNER or owner/builder) PRINT NAME 5�� I C_
State of Florida, County of St Lucie Coun
" SIGNATURE OF NEW GENERAL CONTRACTOR
PRINT NAME SCOtt Harala
V State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this by The following instrument was acknowledged before me this
5 day of May 20 16 ,
Scott Harala day of May 20 is by
who is personally know to me Scott Haralr
or who has produce aq M who is personally know to me
or who has prod ce as IO.
DENISE BROWN
Signature of No =:' Commission FF 140607
Expires November 4, 2018 Signature of Not '`�0607
°O= I ROW
* j, pd e„°,Bonded Thru Troy Fain Insurance 800-385-7019 C'��IS$10 N
Only signatur VAF�°; ` Cx • n # be 4 201
ange of subcontracto gip; h°�� plres November4, 2018
r Bonded Thru Troy Fain Insurance 800385.7019
Revised 07/21/19