HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASESELECT ONE OF THE FOL LOWNG:
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 $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. l .
Date: �: Permit Number:
Site Address:
:A LeoState Licens - ' . `g�.9.q!5;f SLC License.
Origin GC, subcontractor or owner/builder
1AAe S t�- t)1 .n . State Licensl MkIl SLC License
New GC, subcontractor
Reason for Cancellation
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 bcontractor or ancellation of permit. A permit cannot be cancelled if work has been performed.
SI URE OF OWNER (or owner/builder) ,\ SIGNATURE GM- RAL CONTRACTOR (ornew GC, as applicable)'.
PRINT NANE,(6V (k t ' %4—DW11)0r�-+ PRINT NAME
1
State of Florida. County of St. Lucie County State of Florida, County of St. Lucic County
TXc following instrument was acknowledged before me this
day of 20JJ, by
— w o is personally known to me
or who hai ptrd�i � . as [D.
Signature of Notary Date
Revised 04/15/16
4yyr n� Notary P011 State of Florida
° sa Leone
_' Sand 020251
My Ces00�t ,02 20
t3xp-
'Mwtt
The following instrument was acknowledged before me this
day of , 20_, by
who is personally known to
me or who has produced as ID.
Signature of Notary Date
93
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc. have agreed to be
(Company Namellndividual%hme)
the Plumbing Sub -contractor for D R Horton
(Type of Trade) (Primary Contractor)
For the project located at $OS Cvli/'1'TL'
(Project Street Address or Ptopetty Tax ID #)
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 St. Lucie
filing of a Change of Sub -contractor notice.
CONTRACTOR SIG, ualifier)
Brian W. Davidson
PRINT NAME
CRC 1327068
COUNTY CERTIFICATION NUMBER
State. of Florida, County or Breyard
The foregoing instrument w s signed before me this,day of
' 20 by
whq-Is personally known _or has produced a
asildtif1 align.
LLL i.L��y+r( STAMP
Signotdre orNotory Public
Sandra Leone
Print Name orNotary Public
Revised I V1612016 a •r, !
will be advised pursuant to the
David W. Meek
PRINT NAME
CFC057372
COUNTY CERTIFICATION NUMBER ,
State of Florida, County or
The foregoing instrument was signed before me thi day -of .
20,11. by
who is personally known or has produced a
as nation.
STAMP
Sign in of Notary Public
Sandra Leone
Print Name of Notary Public
SC r'ct
Y`'. R. r' a .• _ .
W