HomeMy WebLinkAboutCHANGE OF CONTRACTOR8CAWN,ED
BY
M. Lucie County. .
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING :DIVISION
2300 VIRGINIA AVE RECEIVED
FORT PIERCE, FL 34982
(772).462-1553 FAX 462-1578 AUG 14 2018
ST. Lucie County, Permitting
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement. must be filed in the .new contractor's name
for job values greater than $2,500 ($7,500 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.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is.a $50.00 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
cancellation of the permit.
Date: AUGUST 10,2018
Site Address:
Permit Number: 18070191
J R WONNELL PLUMBING LLC State License CFC1427879 SLC License
Original GC, subcontractor or owner/builder
State License SLC License
New GC, subcontractor
Reason for Cancellation HIRED. NEW.SUBCONTRACTOR
The undersigned does hereby agree to indemnify and hold harmless '
costs, fees or damages arising from any and all claims of action for
contractor/subcontractor or cancellation of permit. A permit cannot
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 known to me
or who has produced as ID.
AUGUST 10,2011
Signature of Notary Date
Revised 04/15/16
gent _and a ployees from
a r Iftf�iis change of
SIGNATURE GENE CONTRACTOR (or new GC, as applicable)
PRINTNAME G G MORABITO
State of Florida; County of St. Lucie County
The following instrument was acknowledged before me this
—it)—day of ALin 20k_J_ by 11"(O�G bt iz,
who is personally known to
me onwho has produced as ID.
'Ar,,,,,,a 0(�a_�d,AUGUST10,2018
Signature of Notary Date
,,%Y po",c
LAURAJ. COLWELL
W COMMISSION # FF 909072
* *
N� r
EXPIRES: April 6, 2020
�rFOF F�o�`o
Bonded Thru Budget No" SMvi*
a.o�
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
=RECEED
o
BUILDING PERMITSUB-CONTRACTOR AGREEMENT
Pl mbing By Bishop/James,M. Ager'CFC1.429566 have agreed to be
(Company Name/Individual Name)
t Plumbing Sub -contractor for GM Construction LLC
(Type of Trade) (Primary, Contractor)
.F the project located at ,2105 Greenbriar Lane, Palm City, FL 34990 Property TaxID #4425-701-00.55- 000=9
(Ptdi:ect Street Address or Property Tax ID #)
It s understood that, if there is any change of status .regarding our participation with the above mentioned
..
pr ject, the Building and Code Regulation, Division �of St. Lucie County will be advised pursuant to the
h �I ng a of Change of Stib=contractor notice.
C N rAC RTO 'IGNATURE B-
(Qualifier. ) SU CO TRACTO IGNATURE (Qualifier
Ap��
Jet, et, i'Yl. e S J � t � Aar -
PRINT NAME
C UNTV CERTIFICATIONN NNUMBER COUNTY CERTIFICATION. NUMBER
St to of F1orid3, County of State of Florida, County of MA a 1 N
T c foregoing instrument was signed before me this 9 day of The foregoing instrumeat was signed before: mh tbis q7_"'day of
� 20 Vb ,G.r
20_Z by.
w o is personally known t�or has produced a . who is personally known.. ✓r has produced a ..
a lidentification. ns identifi . n.
STAIIAP "' ?�''� LUCINE. KHATCHSFrAI4�i CHAN
S nature of Notary Public Sign cure of Notary Public ;•; .'i MY;COMMISSION # FF992837:
' EXPIRES May 16, 2020.
`) I /
0U✓TL l LO �( V`� j `j Q �� , Flaldallo Sarviee'.cocn
.... LVf_A 1 L '6-- t:G� Q.hsLh f4 7 .. .. .
P IiatNume of Notary Public Print Name of Notary Public .
LAURAJ. COLWELL .
..
MY COMMISSION # FF 9990M
rt
u} a� EXPIRES: W 612020
Bonded Thru Budget NOtary SCAM.
wised 11/1tiYL016