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Change Of Contractor
PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION . 2300 VIRGINIA AVE RECEIVED FORT PIERCE, FL 34982 MAY 0 5 2022 (772) 462-1553 FAX 462-1578 St. Lucie County Permitting CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT . PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor. CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general. contractor. The new "subcontractor must fill out a Subcontractor Agreement Form. There is a $5.0.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the .owner and qualifier of record. There is no fee for cancellation of .the permit.. Date: 3/29/2022 Site Address: WYNNE BUILDING CORP. Original GC, subcontractor or owner/builder GOLDSTAR ELECTRIC, INC. New GC, subcontractor Reason for Cancellation Permit Number: 2110-0547 License SLC License 8898 License EC13002082 SLC License 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/subcontract cellation of permit. A permit cannot be cancelled if York has been performed.. SIGNATURE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable) PRINT NAME. MATTHEW LYLE WYNNE State of Florida, County of St. Lucie County The following instrument was acknowledged before me this .2�dayof IW,4.eC-11,20_"by ! f!wLYLEYNNE )t who is personally known to me or w has roduced as ID. Q,a - 3/29/2022 . Sig re of Notary Date Revised 04/+5 k6YP��` DOROTHYANNBASKIN MY COMMISSION # HH 045443 EXPIRES: October 2, 2024 FCF F1 0,` Bonded Thru Notary Pudic Underwriters PRINT NAME MATTHEW LYLE WYNNE State of Florida, County of St. Lucie County The following instrument was acknowledged before me this day of I I ! &jC K�, '20� y �-H-ME W NNI. X who is personally known to me or who as pr uced - as ID. /29/2022 Signatur o Notary atEh?, ;•..__,_ =,-" DOPOTHYA14NBASKIN MY COMPvtISSION # HH 045443 pFFLii E.(PIRES:October 2,2024 burd d'IhruMOts 'PublicUnden+riters IPERWT # ISSUE DA, TIE PLANNING & DEVELOPMENT SERVICES Building & Conde Comp4ance Division FiECEIVEP) BVIL INN PFRXJT MAY 0 5 2022 $US-CONTWTORAGREEMENT St. Lucie County Permitting GOLDSTAR ELECTRIC, INC. have agreed to be (company Name/I ivi ivad wa,=') the F-t.ECTRICI _ _ Sub-contrwlior fDr (NNE DEVELOPMENT CORP. ,{Ty.peofT>ade�' 2 [� (himaryContracwt). For the project located at (Pr,QjW SS or Property Tax 'ID It its understOOd fleet, if *ere is au.Y changi of status regarding our participation with the above mentioned project, dw Building and Code Reguiatiou Division of St. "Lucie County swill be advised pursuant to the filing of a C bange of Sub -contractor notice, 4C011tMCT0R $itGxATURE r(Q"HGea') MATTHEW LYLE WYNNE PMST NAME COUNTY CEWMIdCA'd'ION -NUM 3ER State of'Fiorida, County of ST. WCIE The foregoing instrumentwassigned before we thfg ` day of N�,kG C C.h ,2-y IU�A3"THEW L�'LE9f�9�9 Who b Fenn atiy known -L6r bas Iarodueed a as id"fla"Won. '•'.� �nI .I. _Irr. �� � � e l DOROTHY BASKIN Pa4nt'Nowe of3Noh" Paiw OD ROTHYANN BASKIN MY COMMISSION # HH 045443 �9,�% zo •' EXPIRES: October 2, 2024 Bonded Thru Notary Public underwriters Fea/SEd 11461291� r 1-91: R-GO NTRAC3OR SIGNTATURE Qualifier) JGHH CAVIAR PRINT NAME Cf9UNTV CERTIFICATION RUi-ER State of Florida, County of ST, lLUCll£ The foregoing instrument was signed before me this 0( day asC,V\ ,20�yJOHN CAVNAR arho is peasonatly 1M0W-n or has produced a Duel V"S to c6rmse es 3dent5IIcarion. STAMP S%naigareofiNotary ub ie ©OROTHY BASKIN PrintNameof Notary public ��GlS�+S1fiWy.A++4R DOROTI-IYANN BASKIN MY COMMISSION # I-IH 045443 EXPIRES: Oc () OJ' 2, 2024 Bonded Thru Notary public lrndeiywritersD'+.CAYc