HomeMy WebLinkAboutCHANGE OF CONTRACTORSCANNED
BY
PLANNING & D.EVELOPMENT SERVICIS
BUILDING &.ZONING DIVISION RECEIVED
P
2300 VIRGINIA AVE
µ FORT PIERCE, FIB 34982 S E P 21 2018
(772) 462-1553 FAX 462-1578 . 9T. Lucie county, Permitting
CHAN:GF .OF CONTRACTOR SUBCONTRACTOR OR, CANCELLATION OF PERNIT
PLEASE SF,LEC'r ONE OF THE FOLLOWING.,
X 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 trust be filed in the new contractor's, name
far .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 $56.00 feefor the.Change of :Contractor.
CHANGE OF SUBCONTCRAC70,11— Subcontractor changes are to be.complete'd by the,general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is.A.550.00 fee ror 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 be signed and notarized by both the owner and qualifier Of record: There, is. rib fee for
cancellation of the permit.
Date: 9-Q�W/2018
Pm ertt.Numbe . 0 0 ,J < ` '
Site -Address: 6285, Old Dixie Owy,.629.0 N. US I-iwy,1, Port St, Lucie, FL: 3494
5UNRIS.CCt7Y COMMUN.I'(Y ry0U04d UGVCLOP.rdEN1' 4R6A tJl?An6N,l QC(oaANainut Stale License CGC9515f114: SL C License
Original GG,'subcontrtictor or ownerlbtdIder
Wells Brothers. Construction Co., Inc CGC 1508.154
-State License SLC License
New GC, subcontractor
Reason for ICancellation Owners needed a General Contractor who could work with PA Project lvtanagpment'Ceam
The undersigned,does hereby agree to indemnify and hold.harmless St Lucie County%�',,'Jfs,off cis, gcn nd emp, gees from all
costs, fees or damages.arising from any apdqill claims of action for any reason,,I t arise s a', ul P it' change of
contractor/stu ontractor or c nc'ell ' rt Of i 'ir,A' permit cannot. be.can If i orl: h .b
tiiGNt? Litt ?i7FC)whlJ pra)Ftiterlbt i r)'ttir new G ; as applicable)
L151
titate nrfhtridA, County or Si..1:ua�LUGtrunt}�
'the rallowing instrument wits acknowledged heibre tite this
t"31 , oi- Septemver N)� by tJOL
t wi is pmg�oonally kno"l I to me
All N6ohas
U4ignalure; ofNola ry pate
State of Florida, County orSt. Lucie County
'nic following instrument tvss.acknowledged:bcloreme this
N. Any, oi' sap 4& .20 ya by
Michael David W//ell who ispersomillyknown to
the or wino InI, etruced as ]D
9-14-18
b" 'ignatturco,No��ta�ry�..� .bate
r?evisesi eatis=/i COMMONWEALTHOFPENNSYLVANIA
NOTARIAL SEAL`
Gristel'Ortega, Notary Public,
Lower Paxton ToWnship, Dauphin County.
My Commisslon Expires March 30, 20E1
tN'Y°tine ROBERTMOLLET
�9 OTc� MyCOMMISSIONi.FF682409
EKPIt7Es: Juno 3, 2020
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