HomeMy WebLinkAboutCHANGE OF SUB-CONTRACTOR02/09/2018 12:31PH FAX 7724663765 APPLEBEE ELECTRIC �1 0003/0004
FED/09/2018/FRI 10. 07 AM P�___ age/Chief lend FAX No, 352-4;-., J671 P. 009
PLANN NG4& DEVELOPMMNT SEk VYCpg
BUILDING & ZONi NG DMsION
2300 VItGTN'LA AV'E
FORT PIERCES VL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CQNTRACTOR, ,YJBCt7nR&c TOR OR C�NOEX,L T ]� OF PE M'r
PUMP, ECT ix o
ORANGE Olt±' CONTRACTOR — Change Of'Contactor is to be signed and notarized by the property of ner,
and the new eontmOor ofreeord for tote curmnt.permir, A new permit Application must also be completed with new
coratracxor information and signature. A now Notice of Commencement must be filed in the new contractor's name
;for job values greater tbau $2,500 ($7,500 if A,/C ChWtge,.out). A recorded copy MUSt be Submitted prior to
commencing arty wort!;. There 19 a $50.00 fee for the Change of C-Ontracto,l
k CH"QE OF S><TBCONTRACTOR — Subcontraotor changes ara to be completed by the general contractor,
The new subcontractor mwt fill out a Subcortractor eA$Teement Form, 'L'liere Ss a $50.00 fee fax the C4aage of Sub_
C4ntraetOr.
CANCO-XI LATIM OF PLRM T — The cancellation of a permit is acceptable only iaf no work his begm done.
Canoetfition of permit is to be signed and notarized by both the owner and qualifier of record. Where i% Ito fee far
cancellation of the permit.
Date: Permit N mher:
Site Address! 5408 ibgAL WOLDINp FID,, FT. PIERCH, PL 3087
i aG�riG. State Ucc.nseAs C 4zq r6aq rSL,C Licentie
Origilaal f3C, - ' or owne�r/builder 0 • •--
JAK. IND. d/b!a APPLEBM ELECTR)C State License eG tlnaazssa New _ $LC l.icente 98055
CfC -
Reason for'C$nceilation CHANCE OP ELECTiRIcAL.SUBCONOTRACTOR
Th9 an&isigned does hcrohy Wce to indemnify and hold harmless StLueie'Cauaty, its officals, agents and employesa from all costs, fees or damages arising from any >jn all claims of Action for any reason, which may arise as tt resalC of this change of
c tor/ ubcoittt�cto or Meellatioa Mint. A Permit 040aut be ncell if work has be erfo d.
�T
S30NA Re OF OWNER (or ownor/builder SIt3�T C IJT ( a►v t rCas HAAtieshIe)
PANT siAncE
PTtTN'i'NAM�
State of FlotldN County cf St Lucie County Slane off-lorida, Couruy ofU Lucie Coouey
Th�a PbltOvvy�g iaat:ument was tk�wwieCged before 1ne this
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MELISSAPARRAMORE
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02/09/2018 12:31PM FAX
FED/09/2018/FR1 10:07
7724663765 APPLEBEE ELECTRIC
AM ."f` ige/Chief land FAX No, 352-4, 2671
IM 0004/0004
P. 002
PERMIT#
INC, d/b/a A
1712-0258
ISSUrz DATE
PLANNING & ALV,ELCPmENT Smvicn
ftildiug & Code Compliance ]division
•DYJILDING PERMIT
sUS-CoN"ACTOR AGRE]WENT
EE ELECTRIC
have agreed to be
the ELECTRICAL - •_m
Sub�ontractorj)r & H HOMES
(typeofTx'rade) .
(Primary Gatttractor)
For the project located at 5405 IDEAL HOLDING RD„ FT. PIERCE, FL 34987 3210-111-0003-000-6
(Project Street Aftess or Propc* Tax ID #j
It is understood that, if there is My oliange of Status regarding our participation with the above mentlolacd
project, the Building and Code Regulation Division, of St Lucie County will be advised pursuant to the
fIXinS of Chimge ()f $Ub-Con ctor otice.
co1yTC7 G1i siGNATVgE (Q he =MWNAM
TOR QNAT ueiinar
PRINTNAME APPLEREE
c can >�cA tv Nir
stew of lloridk, County of ,
The forogains instrument wgs sign
ed bbyrare�we 0 9 �Z- 1�9Ay of
w ho is WO IcnMAor hes prod uccd A
xq idontifieatioq,
orNOtAry Pabli STAMP
c
�FNotewy Public ,..
R"bed 11/16/2016
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MYCOMMISSION#G01600
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19055 - STATE LIQENSE: EC#0002956
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snn of idarida, caulAty arm
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20, by Qb7 M. APPLEBFE
avho is persoLell oawn Kor boa produced it
in Ideptifi�gtiosL ��
• �h.d,iyr� .,tn
Siguatu a Of Notary publuc
MELISSA PARRAMORE
P1iht Name o aeary PR e
STAMP
MEUSSAVAPAMORr
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