HomeMy WebLinkAboutCHANGE OF SUB-CONTRACTORL'J I
PLANNING & DEVELOPMENT SER
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
PLEASE SELECT ONE OF THE FOLLOWING:
AUG 17 2018
Pei I'lllitirig a..?ej r,i"j:ment
St. Lucie CoDnty, FL
Tlll1U nC Dll`DMT •..__..�^_
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: t 1 i 2 — nec-*
Site Address: 1�63` 1 Coe:)l/Aa�u� —�%N2
Benjamin Drew State License �C SLC License
Original GC, subcontractor or owner/builder
Meeks and Son
New GC, subcontractor
Reason for Cancellation
late LicenseCxfl57312 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
contracto-ubcontractor r cancellation of permit. A permit cannot be cancelled if work has been performed.
SIGNATURE OF 01 NER (or owncrbuilder) SIGNATURE GENERAL CONTRACTOR (or new GC, as applicable)
PRINT NAME 'QJ(I CUL W . PRINT NAhIE
state ofrlorida, County of St Lucie County
The following instrument was acknowledged before me this
L6 dayaf�,21XI_,by
i"- who is personally known to me
r who a prorlueed as ID.
lure of Notary Date
Revised 04/15/16
public State of Florida
?�'� Sandra Leone GG 020251
pro �y Commission
Explies 0811012020
state of rlorida, County orSt. Lucie County
The following instrument was acknowledged before me this
16 day of August , 20_-13 by
/personally who is personally known to
c or has produced as ID.
8/16/2018
ure of Notary Date
y vu blic Florida
f -- �Iv Sandra Leone
F �o� Expir0z0251
es 0811012020
PERMIT# ISSUE DATE
COUNTY
- "
•• iF,tL,OiRrl,D A -
PLANNING & DEVELOPMENT SERVICES
Building & Cade Compliance Division
BUILDING PERNIIT
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) ! C� + - ,� (Primary Contractor)
For the project located at l l o41VNC
(Project Street Address or Property 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 County will be advised pursuant to the
filing of a Change of Sub -contractor notice. .:
CONTRACTOR SIG, uallrlio St 'CONTRACTORSIGNAT QdalirierY
Brian W. Davidson
PRINT NAV E
CRC1327068
COUNTY CERTIFICATION NUNIBER
State a r Florida, County of BreVafd
The rare oing last meal was signed before me this day of
20ffby
whgis persoaell} known ___ or has produced a
as idc t rcalloa
Signature of Notary Public
Sandra Leone
Print Name or Notary Public
Revised 11/16n016
�� ♦`40.. T dam. `��� �J`JIt,, '"�'I'i�.��%
David W. Meek
PRINT NAME
CFC057372
COUNTS` CERTIFICATION NUMBER
State of Florida, County or---.
The ro"goN instrument was signed before me this �� day of
,.20 �9 �(by
who is personally known _or has produced a
as nation,
STAMP
Sig Lure of Notary Public
4
Sandra Leone
Print Name or Notary Public
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