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Home My WebLink AboutCHANGE OF SUBCONTRACTORPLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE RECEIVED FORT PIERCE, FL 34982 OCT 1 1 2019 (772)462-1553 FAX 462-1578 sT. Lucie county, Permitting CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT SCANNED PLEASE SELECT ONE OF THE FOLLOWING: BY CHANGE OF CONTRACTOR — Change of Contractor is to be signed and n0§11hYrt /dy 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. "'A' 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: 10/10/19 Site Address: 4705 Elm Ave Fort Pierce Bradford Electrical Services Original GC, subcontractor or owner/builder FTL Electrical Services New GC, subcontractor Reason for Cancellation Scheduling Conflict Permit Number: SLC- 1905-0350 License EC0001089 SLC License License EC13002850 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 s been performed. SIGNATURE OF OWNER (or owner/builder) PRINT NAME State of Florida, County of St. Lucie County The following instrument was acknowledged before roe this _day of .20_, by is personally known to me or who has produced as ID. 10/10/19 Signature of Notary Date Revised 04/15/16 State of Florida, County of St. Lucie County ac ptvlti ge before me this Y who is nersor alb, known to 10/10/19 gn reof Not Date tgn EL MO'ATEION # GC-007376 June ?9, 2020MaryServica.rl�m PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 SCAN*D (772) 462-1553 FAX 462-1578 BY at Lucie &-4ja CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the properly owner, and the new contractor of record for the current permit. A new permit application must also be completed with now 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 Charge -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 GII 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: I ll��f�l lam_ Permit Number St(ile Address: Akin ELLj A� Fo �r P I F Re xQ!!)E 5�/STFM;�('7� F/o(,,�3 Slate Licensc('�'.C'(�7`l!SLCLiccnsc Original GC, subcontractor or owner/builder Ne GC, r•-I A factor:(ATE-�" S Uf laic LicenscC.CC I _J� 7 C(, SLC License New CC, subcontractor Reason for The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from costs, fees or damages arising from any and all claims of action for any reason, which may a • z as a result of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if wor s been performed. SIGNATURE OFOwNER (arownedbuilder) SIGNATURE GEN •W CONTRACTOR (or new GC..,: applicable) PRINT NAME PRINT NAME KLJ:J farlP.tniF,4 Slate of Florida, County of SI. Lucie Counly Slate of Rorida, County orS1. l.ucio County The following instrument was acknowledged before me this Tijrifpllowing iyct_ e r was acknowledged before me this _day of .20_1 by r_Jl day of iK 20_. by ICr ir1 IbUYV L ei(L who is personally known to me or who has producoe as to. Signature of Notary Dale Revised 04/15/16 who is personally known to me wh � spradt edIt_ as fo 30 a4! ore ofNoWq� hale " ' `• :: ANA M. DEL MONTE dv COMMISSION h GG007376I EXPIRES June 20. 2020 _._nur� �:: 'miMuymv5nvcn.Am r PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 °SCA S? him PLEASE SELECT ONE OF THE FOLLOWING: CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the properly owner, and the new contractor of record for the current permit. A new permit application must also be completed with now 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: _I i _ % j Permit Number: S)s —1 ° c. -03JCS Site Address: 4:7cin � LM AV1 Fc izT P t FC' R_P tSnnr ZSgSTF M:--� L ';:/ QR e)-1A SlateLicensc(:f C'S�'%`�fUASLCLieensu Original GC, subcontractor or ownerlbuilder T+d r11Q H A Z67 R'nTE 11 laic LicenscCL i -i:� Ciao SLC License New GC, subcontractor Reason for Cancellation. �[ Ic 1�Ut ! h) ClJ/v} 1 I 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 as result of this change of contmctodsubcontractor or cancellation of permit. A permit cannot be cancella ' • a ed if rsor s been perforated. SIGNATURE OPOWNER (Of Owller/IIOiIJCr) SIGNATURRGr•N• CONTRACTOR(or new GC.as applicable) PRINT NA14E PRlN7NAME klr4 fE,1A1n re State of Florida, Cnunty of St. Lucie County The following instrument w•as acknowledged before me this 20_, by —whn is personally known to me or who has produced as ID. Signature of Notary Date Revised 04/15/16 Slate of Florida, County of St. Lucic County Ilowing, t e I was acknnwldgcd before, nic this _day of C`J 20_, by I<i M IbusfyyL ML whe is personally known to me wh9 s prod c n+Rndus �^. l0 30 44! ` arc orNolnry Dale ANA M. DEL MONTE AY COMMISSION!G000737E o �S' EXPIRES Jure 29. 2020 I :, nu:; rx cm�nsq.;ary5awrcesorr j --1 M PLANNING & DEVELOPMENT SERVICaFivED BUILDING & ZONING DIVISION 2300 VIRGINIA AVE 130 0 4 40 % FORT PIERCE, FL 34982 Per 5 tt� g DeCp1"N "t (772) 462-1553 FAX 462-1578 PLEASE SELECT ONE OF THE FOLLOWING: St. Lucie County 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: 10/8119 Site Address: Permit Number: 4705 Elm Ave Fort Pierce, FI 34982 Hypluxo Plumbing Original GC, subcontractor or owner/builder Patriot Plumbing Inc. New GC, subcontractor Reason for Cancellation Scheduling conflict 1905-0350 License CFC1430015 SLC License License CFC1428878 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 61seen performed. SIGNATURE OF OWNER or owner/builder ( ) SIGNATURE GENE \tNTRACTOR (or new GC, as applicable) PRINT NAME PRINTNAME /`Y lam'% 1L /7 -� State of Florida, County of St. Lucie County The following instrument was acknowledged before me this _day of . 20_ by is personally known to me or who has produced as ID. 10/8/19 Signature of Notary Date Revised 04/15/16 State of Florida, County of St. Lucie County following iostm mt was aclnowledgell before me this day of n r 201q by 1EkM %0 ftYW4 - t is, personally known to _as ID. 10/8/19 Date ANA M. DEL MONTE MY COMMISSION # GG007376 EXPIRES June 29, 2020