HomeMy WebLinkAboutCHANGE OF CONTRACTOR[,.T 3(-
Planning & Development Services
Building & Code Regulations Division SCANNED
2300 Virginia Ave. BY
Fort Pierce, FL 34982 St Lucie County
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR RECEI!'7D AY& 23 Z016
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
signature, and transfer fee. 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. Subcontractor changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date: 8/18/16 Permit Number: 1512.0408
Site Address: 13316 NW Baywood Place
Richard Manning Woodley State License C13CAl7970 SLC License
Original General Contractor (or Subcontractor)
Scott Harala
New General Contractor (or Subcontractor)
Reason for Change Richard Woodley left company
License CGC1506052 SLC License
The undersigned does hereby agree to indemnify and hold harmless St. Lucie County, its officers,
agents, and employees from all costs, fees, or damages arising from any and all claims of action for
any reason, which may arise as a result of this change of contractor/subcontractor or cancellation of
permit. A permit cannot be cancelled if work has been performed.
SIGNR (or owner/builder) • SIGNAmRE-GF NEW GENERAL CONTRACTOR
PRINT NAME JwfT
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
16 day of Aug , 20 '6 by
Scott Harala who is personally know to me
or who
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Mrs rrequired for change
Revised 07/21/14
PRINTNAME SCOtt Harala
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
18 day of Aug 2016 by
Scott Harala who is personally know to me
or who has produ ed u ID.
DENISE BROWN 6
Signature of Notary Commission # FF 140607
N;• Expires November 4, 2018
of subcontractor Bolo Rn T, F&Ine,veMa tlW3BST919