HomeMy WebLinkAboutCHANGE OF CONTRACTOR 8-16-18y
PLANNING & DEVELOPMENT SE
BUILDING & ZONING DIVISION AUG 1
2300 VIRGINIA AVE 7 2018
FORT PIERCE, FL 34982 LPerrmitting Depar`ment
(772) 462-1553 FAX 462-1578 ^Lucie County, FL
CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERNIT
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: 8/16/2018
Permit Number:
Site Address: 95(C6 DE
Benjamin Drew State License Cj=C'- 1q?AS, SLC License
Original GC, subcontractor or o%vner/builder
Meeks and Son
New GC, subcontractor
Reason for Cancellation
tate License(�E 01,�31312—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
eontracto subcontrac r or cancellation of permit. A permit cannot be cancelled if work has been performed.
NATURE OF OWNER (or o%%mer/imilder) SIGNATURE GENERAL CONTRACTOR (or new GC. as applicable)
PRINT NAME&;&eL (ill. ` PRINT NAME
State of Florida, County of St Lucic County State or Florida. County orSt. Lucie County
The following instrument was ackno I -dged before me this
day of 'U, by
who is personally known to me
6SIgna
who pnxtu"as ID.
of Notary Datc
The following instrument was acknowlLdged before me this
16 day of August , 20_J_8 by
_...personally who is personally known to
or o as protluad as ID.
na�yf c olat f Noy Dale
VState of Florida
Revised 04/15/16` Q otarYPublic 'f°r �^ �
Sandra L ion
GG 020251 ov nua� Nota
$4 Commiss
ry Public State of Florida
4Xpires 0811012020 Sandra Leone
a My Commission GG 020251
�of�Qc• Expires0811012020
AA,
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT'SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc. have agreed to be
(Company Name/Individual Name)
the Plumbing Sub -contractor for D R Horton
(Type of Trade) ,, (Primary Contractor)
For the project located at
ect Street Addre$s or Praperty Tax 1D #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
Droiect, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
co*N-Fmc,rolts[G. ualitier) .
Brian W. Davidson
PRINT NAME
CRC1327068
COUNTY CERTIFICATION NUMBER
state or Florida, County of Brevard
The foregoing instrumeni w s signed before me lhisday of
, 20by
whq•is'`personally known __or has produced a
STAMP
Sandra Leone
Print Name of Notary Public
a. r.. •„r �A.��ypif'M�s
Revised 11l16/2016
David W. Meek
PRINT NAME
CFC057372
COUNTY CERTIFICATION NUMBER
Stale of Florida, County or___ , a
The foregoing instrument was signed before me thi�. day of
20�, by
who Is. persohally known ;or has produced a
as • icalion.
1 STAMP
Sig are of Notary Public
Sandra Leone
Print Name orNotary Public
-A.A h r r'S/ �A"d+'� r.1�"r`?,rih�►yam-{'L.
tC "FCC-,
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