HomeMy WebLinkAboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAN 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELK—r U`Ii Oh'fI IE POLLOWING:
t Cl lx ;E OF CONTRACTOR — C'hange ot'C'ontractor is to be siuned and notarized by the propert}v o\t'ncr.
and the nett' contractor of record for the Current permit. a new permit application mint also be completed with net%
contractor int1brmation and si=mature. A nett• Notice of Commencement mint be tiled in the new contractor's name
for job value, seater than S2,500 (57,500 it' A C Change -out). A recorded copy Inuit be submitted Prior to
conuttencing work. ork. There Is a S50.00 fee for the Change of Contractor,
CHANGE? OF SUBCONTRACTOR � Subcontractor changes are in be completed bt. the general contractor.
-I'hc new subcontractor must till out a Subcontractor Aureenu:nt l brm. There is a S50.00 fee for the Change of Sub -
Contractor.
CANUI.LikTION OF PERMIT --'fhe cancellation uf.tt permit is aeceptable only if no shark has been done,.
Cancellation of permit ip•;to be Maned and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: Permit lumber:
Site Address: , •1 ��La4 Vim- ID�.
�� State l.iccn;t' �c7iC' il
I•icensc__.. -
-_ -- _—
Original GC.' lbeontracu,r or owner builder
�-- ""ZI A State Licen �� tiI..0 License
New 6C, subcontractor
ltea,ou for Cancellation
The undersigned does hereby agree to indcmnif} and hold harmless St Lucie agents and employees from all
co -a:, fc6 or dam.►__e, arising from an} and all claims of action for any reason. tthic'h n0i. arise a, a result oftlik change of
contractor �ubcontractur or• �ancellatihn ot`perinit..!� permit cannot be cancelled if ttorl has been performed.
SI(. \ TS Ill Ill's )tt `Elt �,, ua oar ttullJ�rl SlCi\l l l ftli t it �l H tl.l't )` I IZ \C NOR tirocx (il . a., apliltcahk t
rft1\I N,\fin
State ticHonda. "ant} DrSt, I,uGC ( uuntx
I e'litauwma murunt�nt ua:aat;nnuletlged heliv: tnathu
ul .t is Itcrsonall; kmtun to, me
or echo h: pr�,,d as ID
Signature or.Xotar+ Date
State of Slonda,d'ounq of5l, I uewCounty
the fhtloantg in t ument Na,, icknouledmal bcilirc oic dn,
dat of ")_ b%
>-,ha r per;onall) t.mntn to
mu or who hai prndttced _ _ _. __ a., it),
Signature of Qatar+ {late
Notary Yablic Slate u1 Florida
Sandra Leone
My COMMIasion GG 020251
`+�'+, ••;�j�•<� `p`vortWe Gxpirot'.1811Ji4020
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc. have agreed to be
(Company Namelindividual Name)
the Plumbing Sub -contractor for D R Horton
(Type of Trade) i - (Primary Contractor)
�� For the project located at (� C)� �z 1J�--
(Project Street Address or Property Tau 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 County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
COtiTRACTORSIG, ualifler} 5I=CUti'1'RA'CTORSIGMAXi Qualifier
Brian W. Davidson
PRINTNAME
CRC1327068
COUNTS"CERTIFICATION NUMBER
State or Florida, County of Brevard
The forW,20ffby
rument was signed before me this day of
whq•is personal) known "or has produced a
as tde t oration.
Signature of Notary Public
Sandra Leone
Print Name of Notary Public
David W. Meek
PRINT NAME
CFC057372
COI.tiTI' CERTIFICATION NIt,%IBER
State of Florida, County or_ _.
The roreKa instrument was signed before me this(Do day of
^20V by
who is personally known _or has produced n
cSlgture
ication.
S �A ti1P .
ofNotary Public
W'
Sandra Leone
Print Name of Notary Public
., � �,
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Revised 11116P-016 <
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