HomeMy WebLinkAboutCHANGE OF SUB-CONTRACTORPLANNING & DEVELOPMENT SER F� 9f
BUILDING & ZONING DIVISIONgr
2300 VIRGINIA AVE
• FORT PIERCE, FL 34982 AUG 17 2018
(772) 462-I553 FAX 462-I578 Pe,1�litil'lC��p�-��
St. Lucie County, 1=L
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF P Ili' --
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 CIIANGE 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: i-1 � -. —0�0 .0
Site Address: �0c)" 1�
Benjamin Drew State License—CVC�L"15�?SLC License
Original GC, subcontractor or owner/builder
Meeks and Son
New GC, subcontractor
Reason for Cancellation
tate License OS-'+ 3-'IISLC 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
contractiysubcontracAr or cancellation of permit. A permit cannot be cancelled if work has been performed.
KGNATURE OF OWNER (or ownerbuildur) SIGNATURE GENER.Al. CONTRACTOR (or new GC, as applicable)
PRINT tJAtJY,\64,k k) • Qwilsom PRINT NAME' _
State of Florida, County of St Lucie County
Afollowing in Yrumerit was ac luiged before me this
C/ daya f 'f_0• .by._
~ who is known to me
personally
or who has produced as ID.
Signatuyo ar Notary Dale
Rev i5:d 04%15/
�R,yA` v torida
v
Notary public state o4 F
Sandra m ss oeonPn GG 020251
MY comp8110!2020
Expires
Stale of Florida. County o(St. Lucie County
The rollowing mstruniLm was acknowledged before me this
16 dayor Aupus.(_20_15by
—personally who is personally known to
ma or o as pisxiucc�l II)
8/16/2018
Sirna c or Nolar) Dale
Not Public State of Florida
s° L; Sandra Leone G 020251
e My Commission G
vGaExpires 0811U.�02U i�
., or F40 _
i3b
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 Iocated at 0-WAN-0— cc,
(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 SICc 4 ualifier)
Brian W. Davidson
PRINT NAME
CRC1327068
COUNTY CERTIFICATION NUMBER
State of Florida, county or Brevard
The foregoing instrument assigned before me thi doyur,
,2 by
wh/- personal'. nowaor has produced a
as idecation.
SrAS1i'
Signatdre of Notary Public
Sandra Leone
Print Name of Notary Public
1, s*. n't,�rr,�F\� °r.�t�r'�r" :lam• p
Revised 11116/2016
David W: Meek
PRINT NAME . .
CFC057372
COUNTY CERTIFICATIONNUMBER
state pf Florida, County of
The
/foregoing instrument was signed before me thisaD day of
IV
!4 ` ' by
who is pens ally known _or has produced a
as' cation.
STAMP
Slg ure of Notary Public
Sandra Leone
Print Name of Notary Public