HomeMy WebLinkAboutCHANGE OF CONTRACTORr_-j
Planning & Development:Services
Building & Code Regulations. Division
2300 Virginia Ave..
IF Fort -Pierce, FL 34982
(77.Z)462-1553` Fax 4b2-1578
CHANGE. OF CONTRACTOR
Or Subcontractor or'Cancellation of°Permit
Change of Contractor is to be completed by the property, owner, and the.new coniractorof record for the,
current permit. A new permit application, must also be completed with. new contractor information;
signature, and.transfer 'fee. Anew Notice of Comm
encement must be 1"iled in the new" coritraGtor's
:name for job. values greater than .$2,500 ($7 00 if A/C Chahke-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 execute,:d by both the
owner and qualifier of record.
Date: 5/8/17 Permit ,Number- r �'0�43U
Site Addr`esst 116 ocean Estates brive Fort Pierce, FL.3.4049
t' Jt=YPX/1� State License SLC L cense4 / 9rej
riginal General Contractor (or Subcontractor)
Comet Electric.& Equipment; LLC State License ;EC13002784. SLC. License
New General Contractor (or Subcontractor)
Reason for Change
1lie Undersigned.does'hereby agree -to., ndemnif and hold haimless St.,Lucie County, its affcers,.
agents, and.employees from a11:,costs,. fees or damages arising from any and all claims of action for
any reason, which, may arise as-a.resuli of this' change of contitactor/subcontrae or or cancellation of
permit, Apermit cannot he cancelled if work has been performed.
SIGNATURE. OF. O R (or.:ownerabuilde w SIGNATURE OF NEW C,EN RAL CONTRACTOR
PRINT NAME PRINT NAME Mark L.Urtz
State.of Florida, County of St. Lucie County
oilouring in lent was acknowled ' d efore'me this:
.day of 12dj. b"0'
e IVwho,rs personally know to me
ors ho rs<pmduced_ as
Signature of Notary 0 Date
*Only signature required for f
Re.rised 07/ 1/ xnt,% Notary Public State Of FlOrlda ,
Frances Dona
a 1 21
Commission 092d�J�
of�o� Expires0712712021
State of.Fiorida, County of St. Lucie County
ilt�eyfollowing instrument was'aeknowledged before me this
8 ddy of . 20 %l. byA6lli%C� litJ✓ Z
Is personaliykii to me,
or who has roduee as
na ure o otary Date
.-
� 0 arr Notary Public State of Florida
Tonya Adkins
My,commisslon.FF 207105
,Expitea 63109120119,
PERMIT # 1 1 ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING.PERMIT
SUB -CONTRACTOR AGREEMENT
Mark Luttz/Comet Electric &.Equipment, LLC have agreed to"be.
(Company Nair.0.1ndi-Aduat.Name)
the Electrical Sub -contractor -for .Phoenix Companies
(Type of Trade) (Primary Contractor).
For the,project located at 116. Ocean :Estates -"Drive "Fort Pierce FL 34049
(Project Street Address or Property Tax ID #
It is understood that, if there is any change ofstatus'regarding our participation with the :above mentioned
project, the. Building and Code Regulation Division of St. Lucie County wilybe'advised'pursuant to the
filing of a Change of Sub -contractor notice.
VINTi2ACTOR —SIGNATURE
G 6W�
'PijiNT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me.this 11?_day f
,20aby
who is personally known _or has produced a J
as identification.
STAMP
Si nnture.of Notary Public
Print Name of Notary Public }�
�Y tvotary Public State at Florida
Frances Donna
• c MY Comm1sston GG o9,-0
cr�o� Expires0712712021
Revised 11/16/201
v Z'z
SUB -CONTRACTOR Sf j3NATi7RE (Qualifier)
Mark Lurtz
PRINT NAME
160iEC13001784
COUNTY CERTIFICATION. NUMBER
State.of Florida; County of _Palm, Beach 1-4
TheiLV
foregoing instrument wassigned, before me this P day of
A .
who is personally krfpwn _2Lor:has
r
Notary P#blic
otipava�.
4;r TOY! Public State of Flo
ox _ rya Adkins nda
fAo4� MYGornmiastonF
lrea F207705
�kP03/09[20t9
STAMP