HomeMy WebLinkAboutCHANGE OF CONTRACTORSCANNtu
BY
�4 �uCie Cal Intt
PLa\''ING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIIERCE, FL 34982
(772) 4 I2-1553 FAX 462-1578
CHANGE OF CONTRACTOR. SUBCONTRACTOR OR CA`CELLATIO` OF PERMIT
PLEASE Sl:r.i:Cf om: OF THE FOLLOWING:
CII:�\GE OF CO -,TRACTOR - ,Change of Contractor is to be si�_ned and notarized by the property owner.
and the new contractor of record for the current permit. a new permit application must also be completed Willi new
contractor information and sienature. A new Notice tit' Commencement inust be tiled in the new contractor's name
ror jab values greater than S2,500 (S7.5ci0 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 - Subt:ontractor chan-es are to he completed by the general contraelor.
'I'hc new subcontractor must till out a Subcontractor A_,reenient I-orm. There is a $50.00 fee for the Chance of Sub -
Contractor.
CANULLATION OF PERMIIi - The cancellation of it permit is acceptable only if no work hits been done,
Cancellation of permit is to be signed and notarized by bath the owner and qualifier of record. There. is no fee for
cancellation of the permit. I
Date: 0 Permit `'umber:
Site Address: U�Ci� L0 J� `--
Y� �yvL State I.iec n,t) s.:. L7C' License
Original GC'.-iibcuntractor or caner builder
State f icens - a' SLC° License
New CIC, subcontractor I
Reason for Cancellation .
The undersi!zned does hereby auree to indemnify and hold harmless St Lucie County, its orticeri. agents and employees from all
co�t�. fees or damages arisin_a t am any and Alf claims of anion for any rra:un. uhi¢It ma}`uri,e a> a result ufthts chanZ7 ut'
contractur'-uhcontractor or •ancellatiunlof permit. A permit cannot be cancelled if Rork has been performed.
I
Sit 'II'H� t)i•tilivl!R(ort)%Gerhutl510%kItRl:oil:`1'R\!,(•t)%Ilt.1t"loltwrnew,( miapplicahleI
:.:..`._ 11V iG'i a'E Ll� �lat�lt��,v PRt.t ti �,It., _
titatc atTlontfa. Count) orit Lucie counts; tit tc urFlnnda. (Hunt\ .+f'a I wne Count)
1 c lidluw ml In>tnunt.'n[ µus ac{,nnw I+alycd tirt6r. me this I he tidLw+utg utswaant wit.: a�6noµlctlgn! heft+n Inc Ih+s
tia) of
Q•r t µ , i; pers+lit.ill) l nnµn to Ina µhu t; personall; Lnuwn to
ar µhu ha pN
as IU In%: tit who has pmdua'tl ,ai ID
Sh-nature or \otar) Date ' ^� Signature of Yolan Date
i
a
r .
Sate of Florid
mnVis:ioavG02fi51
ti�X���l`. LwS Cs...._1�i�i
a n i
PERMIT #
ISSUE DATE
, PLANNING & DEVELOPMENT SERVICES
Building* Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Meek & Sons Plumbing, Inc.
(company
the Plumbing
(Type of 7
For the project located at
Name)
Sub -contractor for D R Horton
(Primary Contractor)
(OD-1 . C a
(Project Street Address or Property Tax
have agreed to be
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
Brian W. Davidson
CRC 1327068
vision of St. Lucie County will be advised pursuant to the
fi
SL O\-fI6VCfOR SIGNATt Qualiliery -
COU.NTY CERTIFICATION NUMBER
State of Florida, County of Breyard(�
The foregoin Instrument was signed before me lhi3" " day of
2L, by
i
whq ii personally known _or has produced it
ns ide n cation
1L��e L ,-If� ST,%MP
Signature of Notary Public
i
Sandra Leone
Print. Name orNotary Public
i
i
Revised I1l16l016
1,
David W. Meek
PRINT NAME
CFC057372
COUNTY CERTIFICATION,NV,INISER
state or Florida, County of
The foregoing instrument was signed before me this 2 Way or
. 2) �. by
who Is person' ty known _or bus produced a
Its icattoIL
�. STAMP
oftary Public Sig tore No
Sandra Leone
Print Name of Notary Public
t0 ,F"aa1:l
r