HomeMy WebLinkAboutCHANGE OF CONTRACTORt:J
PLANING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2A0 VIRGI``IA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR. SUBCO`'TR-kCTOR OR CANCELLATION OF PERMT
PLEASE SELECT Otli Oi= T111: FOLLOWING:
;XCIIA\C;E OF CO\•TR\C'FOR — C'hanue of Contractor is to be signed and notan7,ed by' the property o« ner.
and the new contractor of record for the current Hermit. a new permit application must alto be completed «•ith nt:«
contractor intbrination and siunature. A new Notice of Commencement must be tiled in the ne«• contractor's name
for job valuc, ;greater than $2.500 (S7,500 if AC Channe-out). A recorded copy must be submitted prior to
commencing, any work, "There is a S-0.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the g=eneral contractor,
The new subcontractor must till out a Subcontractor Aarcement Dorm. -There is a S50.00 fee for the Change of Sub-
Contractor.
. CANCELLATION OF PERMIT — The cancellation of permit'is acceptable only if no work has been done.
Cancellation of permit is to he siC_ned and notarized b�- both the owner and qualifier of record. 'There is no fee for
cancellation of the permit.
Date: � ' Permit Number:
Site Address:' U(J CO b33ISUJ'L 0C
State I.fcen,t 7 T.0 License
Original Q , - tbt mtractor or on•ner•builder
State i.iccn � � _SI_C Licen%i:
New GC, subcontractor
Reason for Canecllwk-)n
The undersigned does hereby agree to indemnify and hold harmless St Lucie County. it; officer, agents and employees from all
cost;• fec+ or damage; arising from any and all claim; of action for any reason, %%hick may- arise a. a result ofthis chance of
contractor. •ubcontractor or anecilation of permit.:► permit cannot be cancelled if work has been performed.
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Stair 411TIimtle. Counq pt'it, Uvoe County
e.11111uu ing, MA17uu101'Aas ueknnulcdgcd hctaro ens thi
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or whoha. p ed. as11)
signature of Natar+ Date
State orFlomtki. Count% of m. WeicCount%
1 W ti11k1u trig in+trunilmt was; acknou ledpat halive ino this
day of 20_ by
who is peminally known to
incur who h:i� produ"•d as 11).
Signature af .Notary Dote
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I PERMIT # I I ISSUE DATE I I
PLANNING & DEVELOPMENT SERVICES
rm- mn: ; WIM—Wo"WTV 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
Tyi;of TWC') (Primary Contractor)
)OS 1�&Q. 1V7)
For the project located at C 0 W, 'A
(Project Street Address or Property Tax ID A)
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
riling of a Change orSub-contractor notice.
CONTRACTOR SIC tuliRer)
Brian W. Davidson
PRINYWA—MIK
CRC1327068
COUNTY CERTIFICATION NUMBER
Slate of Florldn,,Counly of, Brevard
The ran ping Intirumani was, signed beraft me this d y of
L by
wh persoAdly known .. or has produced a
as�tde atlas
STAMP
Signeldre orl4alary Public
Sandra Leone
Print Name orNatary public
............
E,:- Ira L, Onc
G3 02045
0 Revised 1111616
David W. Meek
PRIM' NAME"
CFC057372
COUNTY CERTIFICATION NUMBER
Slate of Florida. county or ---
The raregminig Instrument was iiXord berare me A64 day of
QA A. by
w6b is ersiYally known _or has produced a
Sandra Leone
Prial Name of Notary Public
11e.21 F:c: do
GG -310�5 I
U20
ti
SCAMP