HomeMy WebLinkAboutChange Of Contractor.J
PLANNING & DEVELOPMENT SERVICES .
BUILDING & ZONING DIVISION RECEIVED
2300 VIRGINIA AVE MAY 0 5 2022
FORT PIERCE, FL 34982
(772) 462-1553 FAX 4.62-1578 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.
X 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 $50.00 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
Permit Number:
Site .Address:
WYNNE BUILDING CORP.
Original GC, subcontractor or owner/builder
GOLDSTAR ELECTRIC, INC.
New GC, subcontractor
Reason for Cancellation
2104.0685
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/subcontractor r cancellation of permit. A permit cannot be cancelled if ork has been performed.
SIGNATURE d010WFCnQor 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
MAM.r�dayofi�7A/e�,20�bby EWLYLEYNNE
X who is personally known to me
or who has pr duced as ID.
3/29/2022
Signat6lof Notary Date
_=24
4
DOKIN
Revised 0 MY CO045443
:m: YT4
o: EXP2024Bonded Tderwriters or FL°
PRINT NAME MATTHEW LYLE WYNNE
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
L_qday of AlAQ C./ , 202Ay MA'rtNEW LYLE WfNNI
X
who is personally known to
e or who has produced as ID.
3/29/2022
Signature otary Date
of"•`Y'•b6 ;
DOROTHYAN N B ASKIN
MY COMFAISSION
# HH 045443
•'' ; OP `rL�:�
EXPIRES: October 2, 2024
E)nded Thru Notsry Public Underwriters
TIw II r< # iaf DATE RECEIVED
PLANNING & DEVELOPMENT SERVIcEs MAY 0 5 2022
B»Wlag & Cede Irompilance Division St. 'ArrrittiRnLUcie County
f
BUILDING PERMJT
SUB-:CONTRAaCTOR AOREEMENT
GOLDSTAR ELEC:TRJC, INC. have agreed to be
(Company dame/iadavi" N )
ELECTRICIAN sub-eontmetgr for WYNNE DEVELOPMENT CORP.
(Type OfTM&)
For the project located at
(Project Street
1
I �,_ Q
slr Property Tax im
(Primary contractor)
n
It is understood that, if there is any change of status regarding our participation With the above mentioned
project, the Building and COde Regulation Division of 3t. Lucie County +will be advised pursuant to the
filing,o.f a Change of Sub -contractor notice.
CtDi\pI UCTOR SI,GNATUM (Quaiit q)
MATTHEW LYLE WYNNE
PWNT NAME
COUNTY CEIiTIFiCAaIONIAiiill7$I;R
State of E1orl4 County Af ST. LNCIE
The foregoing insfrument was signed before we thli&�K ` day of
\cs r'C�\ .Q• ,y IUTATMEW LYLE WYNNE
who is personegy known AQr bas preodnced a
as identification,
27322,1 ff, 11
f
DOROTHY BASKIN
Print same of Netory Public
DOROTHYANN BASKIN
fir?'• 4c+:
•`; *: MY COMMISSION # HH 045443
EXPIRES: October 2, 2024
.. ' Bonded Tb ru Notary public Undemmers
1�vSsed ilk �%�4i�i6 ���'•%��'�°'"'°�°"r_
TOO-CONTRACTORSIGNATME(Qualifier)
JOHN CAVNAR
P1"SNT IVAME
EC13002082
COUNTY CERTNI CATION NOW -ER
StateefBforida,Countyof $T. LLICIE
The foregoinginstrument was signed, before me ihisday
,3�as-i✓V\ ,zo�y JOHN CAVNAf�
wbo is personally Amown or has Produced a 12 u@ I V"S LeCC-NSe
as identficatiox
`w ��' STAMP
SlgoaturefofNotary ub c
DOROTHY BASKIN
PrintName of Notary Public
:�1Y�k.�,Z7sUA:f.^
,• •iNfN nfi ' ��.iba�aum��n
•5�;; UOROTHYANN BASKIN
MY COMMISSION # 1-1H 046443
EXPIRES: °,°F,; October2, 2024
Bonded Thni Notary public lli,derymters