HomeMy WebLinkAbout1804-0784 change of contractorBy
Luclok Colt,
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
I (772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be comp]
current permit. A new permit app
signature, and transfer fee. A new 1
name for job values greater than
submitted prior to commencing a
contractor. Absent extenuating circ
owner and qualifier of record.
Date: November 5, 2018
RECEIVED
NOV 0 5 2018
ST, I,u0 �Qwnty, Permittin
ted by the property owner, and the new contractor of record for the
.cation must also be completed with new contractor information,
otice of Commencement must be filed in the new contractor's
$2,500 ($7,500 if A/C Change -out). A recorded copy must be
Iy work. Subcontractor changes can be completed by the general
unstances, a cancellation of permit is to be executed by both the
Site Address: 1107 33rd Street, Ft .Pierce] FL
VILLANOVA CONSTRUCTION INC.
Original General Contractor (or
New General Contractor (or Subcontractor)
Reason for Change Owner does not want to
The undersigned does hereby agree to i
agents, and employees from all costs, fi
any reason, which may arise as a result
permit. A permit cannot be cancelled if i
SIGNATURE OF OWNER (or owner/builder)
PRINT NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of , 20_, by
who is personally know to me
or who has produced as ID.
Signature of Notary Date
*Only signature required for
Revised 07/21/14
Permit Number: 1804-0784
License CRC1 327518 SLC License
State License
with job. NO work has beer] elo v e
SLC License
-mnify and hold harmless St. Lucie County, its officers,
or damages arising from any and all claims of action for
this change of contractor/subcontractor or cancellation of
•k has been perfo
�#SiGNAfum OF NEW GEftkACcoNTRAcToR
PRINTNAmE RAYMOND R. VILLANOVA
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
0 J day of Nov. 20 1 eB , by 0)
\ . 1) 1 1 1 a L /f K2.n ho is personally know to ems'
or who has produced as ID.
of Notary / ) Date
of subcontractor
"�,•. $HIRLEY K. BEMENDERFER
r �'£ Commission # FF 989655
.Y :.j,,Z. Expires May 8, 2020
%
Bonded Thru Troy Fain Insurance 800.386-7019