HomeMy WebLinkAboutCHANGE OF CONTRACTORSCANNED
BY
St. Lucie Cou*
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 FAX 462-1578
CHANGE OFCONTRACTOR. SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOMNG:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized.by the property owner,
and thenew contractor of record for the current permit. A new permit application must also be completed, with new,
contractor informaiion,and signature. A new Notice of Commencement must be filed in the new contractor's name
for lob .values greater than . $2,500 (57,500 if A/C Change -out). A recordedcopy must be submitted prior to
commencing, any woric. There is, a S50.00 fee for the Change of Contractor.
it :CHANGE OF, SUBCONTRACTOR — Subcontractor changes, are to be completed by the general contractor.
-'The new,subcontractor�must.iiil out -a Subcontractor Agreement Form. There is aS50.00 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 '
cancellatlon of the permit.
Date: 10115201a Permit Number: 1806= # j
Site Address: 8753 Cobblestone Drive
BenlarninDraw Piwrnbtrtg State Licen�+Kt q s5 SLC License
Original GC; subcontractor or ownw/builder
Mee -S lit �1212c State LicenwgacD§3mLC License
New GC;strliogntrector
Iteason`for Cancellation Benjamin Drew loft Job
The undersigned does hereby agree to indemnify and hold harmless St Lucie C iirrhp'i
o cer3. agents and employees Pion
costs, fees or damages arising from any and all claims of action for any al as result of.this change of
contractor/subcontractor or c.mmilation'of permit. A permit cannot bed. n alwarmelL.
-SIGNATURE OF OWNER (orowaralbudda)
PRINT `NAME
stiWofFWriJ.i igamiyorSLLucia Couaty
'ilia', (olkwins instnaimt was acknowk*W beke eta Ihit
As_.' (hyor. October ;2o la ..by
personally, known who is perw=;y known to ma
ID.
10t1�18
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p�siteSao°tfto►fda
Boni lhdfi/ LRO�, �QZSt
a►rc°"�"no
. Expires
PRINT
Stale wrnmrdo. Covow orSt. LWw Co-w
The roamms wmunm= was mkmwkdsw beRua nw this
n ftd oarr .2a r!.., by
peni°" ltnoyyri who is p me arty knoant to
Ina ID.
swNuureor'Nalaq Oats
�r �ry Pr�ik $4b d Florida'
SWVN Lem
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PERMIT 6 ISSUE DATE
I W Ply
COUNTY
t L U R 1 13 A -
PLANNING & DEVELOPMENT SERVICES
Building & Qode Compliance Division
Bt'ILDINC PERMIT
SUB-C ONTRACPUR AGREE51E1 I'
Meek & Sons Plumbing, Inc. I have agreed to be
(Company Namc- Individual Name) ,
the P.umbing Sub -contractor for D R Horton
(T)pe of Trade) (Primary Contractor)
I For the project located'at. 8753 Cobblestone Drive
(Project Street Address or Property Tlsx 1D.4)
It is understood that, if there is any change o f status regarding our participation with the abol a mentioned
li
project, the Building and Code Regulation Division'of St. "Lucie Count) %%ill be advised pursuant to the
;i filing of a Change of Sub -contractor notice.
!l 64R"%CaFNR_ . IGVA RFRF IQualifirrl tit COVTRAC-1 OR SICVA I t 14�1"l+ero"
,,Brian W. Davidson
PRIM SA.%l E
CRC 9 327068
'COUNTti URTIFIC.1rioN.SuilliER
State or Flarida,;Cquuty or Brevard //
The foreholnpinurumrot w�assikoed before me tblr�-1� dso or
balm
" ,iiho is pcisoarlly laora&—ar has produced a w �
ai lilt dace.
t re of Notary PuM c
Sandra Leone
Print.Name of Notary Public
Nc. f P
«rc St�90 of Rneda
Lco---e GG026Z59
• , 6, �; ErFt;c
tC1 St
David W. Meek
PRINT NAW
CFC057372
Cot N11 111,RIIFICAI10N Nl MBILK
stale ur tit -rids. County ur,_
The rurnoint:inorunteot wasAxsed before me 1111 6 da) or
.201 f. b
who is penooally knot►n fr has produced a
evil cmll�atlon-
Signature orNonry Pnblie
Sandra Leone
Print Name or Notary• Public
rC QS°t2a a U
l cl,,sd9a
GGde.2;s9eNot
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