HomeMy WebLinkAboutCHANGE OF CONTRACTOR-ELECTRICAL -- -r --- - - - -- -
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CHANGE O:F CON'�'RACTOR
` ;Oi 'Sibuoniti actor 4or°CAncellatYo`n'=of Pe�rrii,t:.
i p hange of Contractoris to be completed by theipiopeity ownei,anti therfiew confiactorof>ecord�for`tlie
orient pertntt A'newv permit•application rntist also be competed with ne�v cont>actoi tlifotinataoii-
lignature,dd traii'sfei fee A neiv Notice of Coniniencement if ust be;filed i><i.athe i><e�` contracfor.'s
><ame`fot �db values,greater thth, ii 500 ($7"Ab If A/C.Change out).; A recoi cleti copy musf.b'e
ubinitted`prior.to,�coininencii g>$any woi IC:�Sub'cohtiactar changes ca, be corrip1: by tlxe general .
r l onti-, W ; Abse>,it extennattng ctieutnstances, a 'ca►cellatron of�ermtt is to be executed by bothf,the ,
ner and q:Ualifier of record �� .
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�aD/ Permit Nlirnber ,� •�iz a5
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State Acense�l L � "SEC License. r r
i �1`Gener 1.
al Coitttactox'.(or;Subeontrac'tor),. ,,GG��'�JJ 5
State Ltcenst -"`r'�� SIC License / �.
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etiv General:Contra for(or=Subcontractor)
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r .. Tie tinders gneci does hereby agree toitridemnify ai d l old hA'Cmless St Ll�bltr 061 city, itsbfficers,l
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and,employees4fi;omall costs,fees, oi�damages_aiisitrg fiom sny and all elairns of`act�on for:
a y reason,which� ay wi se as,a: exult gf�tli eItar}xge;o`f bhV' ctor/subcO_"1Wactol ottarice`llation of"' - • :r
p mit. AUPernnt�,ci►iiuot b� an,�e lied if,ioi le Iras bee�i„Perfoiamed
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N�#TURE OF Q,IYNERF(ort r%hutlder) " [GNATl1EtE OF NEB'GENERAL CONTRACTOR
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St �e of Flon a,County of.Sf.Lucte,Couaty State of Florida County of St Cucic County
'.. ThA folio ne ru lent was aet howled ed befofc me ttus� ` e f bNvi 'i 1 mcn[wqs ao_ owled bbfore ne,this
da of 20�
who is p`crsonnlly know„to me wfio rs pecsotiplty knoiv'to me
or 1�io'ltas profit c``d •u"s 1D or-who has produce �as TD" • - z
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a RES Juty,27 7017 y
4- 0 " sag _ of "subcon�ra tox flt L EYIP S JAty27,2017;=
1 q� Elonded PuMaUndenrxzrc
'Rev sed 07%211;19
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