HomeMy WebLinkAboutCHANG EOF CONTRACTORPLANNING & DEVELOPMENT SERVICES
BUILDIiNG & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 402-I553 FAX 462-IS78
SCANNED
By
Sttudeftnty
C1l:1\GE OF CO\'tRAC'TOR - C'han�1,e of Contractor k to be signed and notarized by the propert}' m%ner,
and the new contractor of record for the current permit. A new permit application ntu,t also be completed with new
contractor information and signature. A ne%i- Notice of Commencement Inuit he filed in the nci% contras W.4 name
for job values _greater than S2,5,00 (57.51)0 it' AC Change -out). A recorded copy� must be submitted prior to
commencing any work. There Is a Sa0.00 fee for the Changc of Contractor.
CHANGE OF SUBCONTRACTOR - Subcontractor cltan-es are to be completed by the uencral contractor.
The new subcontractor must till out a Subcontractor Aureentent Furor. There is a S-50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF ITRMIT -'Che cancellation of a permit is acceptable only if no work has been dune.
Cancellation of permit is to be ,fumed and notarized by both the owner and qualifier of record. -There is'no fee for
cancellation of the permit. I
Date: -� 1 az)
Permit Numher: 0S
Site Address:
�VIA t`J )l w _TState I.icenid� —Nxi*c License `__--
Oriainal GC, - ibcontractur or ottner builder
State Licen;
New (it', subcontractor I
I
Ilea;on for Cancellation
The undersigned does hereby a_aree to indzmniQ and hold harmless St Lucie County. it officer,. agents and employees from all
co -;is. fee, or dam:u_e+ arking from am and all chum; of uciion for an% reason. %%hick may ariic as a result of thi, ehun��e Of
contractor -ubcontractor or •aneellation of permit. A permit cannot be cancelled if noik-has been perforated.
51t, liltlttp111t�[iltturu��narhudderl{<I�tll{tftilS�iR\I,tr)`IR.1i1{tlitnrneutit,r;apph::d�let
;t, U). t71�cJ►,��1J rKt\t `tau`
5tatc 011P10ad.t. t'aunn of t I uctc Crtnntt
Stxte of I•londa. t'uunt� af_St 1 wit: t•outuy
e tiilla«tng tn,tntment was acknou lodged hvfor. me this Ihr hollow utg m+trument was eckna•a ledgcd heti+re the tht:
dati ot` 20� . h} _ _ m _ _ . dad of 'tl_ b�
w +, r+ jlttunalh htn,wn to me µhn n personal!} !.noun to
ar uho ha pr ,: as II] the ur who has produecd - as IU-
Signature of Notar; y Date Signature of Wotan
e. >:
' r+Y&-
i
Date
,+-fro 1 t:om' u4 �7Q?Jt
U
PERMIT# i I I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
01. Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc.
(Company Na melindividual Name)
the Plumbing
(Type of Trade)
For the project located at
(Project Street
or Property Tex
for D R Horton
(Primary Contractor)
have agreed to be
Lob RALo- 'N
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation
filing of a Change of Sub -contractor notice.
CONTRAG70R s1 uliaeel
Brian W. Davidson
PRINTWAME
CRC1327068
COUNTY CERTIFICATION NUMBER i
state or Florida, County or Brevard
The roregoing Instrument was signed berore me thisaDday of 1
-20by
7Id
$personatly known _or hu produced a
e adon.
t
9.rr�{M STAMP
paidiieorNotary Public
Sandra Leone
Print Home orNotary Public
. yf fg.�
Fi• �:ry ti' �'aC ;J Fu11i�J
Revised 11/16016
L . c �� : �s n � o.pc51
�1 t�tci�
L .F.C' Lint'
of St. Lucie
David W. Meek
Rih`r NAM1 E'
be advised pursuant to the
CFC057372
COUNTY CERTIFICATION NUMBER
slate or Florida. County orw,�
The raregotnR instrument was aiRxed berore am Ile day of
by
wbo is personally known or has produced a
u tka.
SW
tare o Rotary Public
Sandra Leone.
Print Name orNotary Pobac
Pe_I r S*:3W ct Rot da
r ;j't W i.Citttt; ,
ey
n:ivOc05iWfj
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