HomeMy WebLinkAboutCHANGE OF CONTRACTOR$ sa .00
COUNTY
F L O R .1 D A
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
/561%0-0w�
SCANNED
St. Lucie county
CHANGE OF CONTRACTOR
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: to 1'; 1j /19
Permit Number: 190(a-646
Site Address: 1 J( o �
o A .'tC 7 • ���p tc -'o 43y jl�
Auqa Dimensions Plumbing
State License CFC05726 SLC License 18e28 I
Original General Contractor (or Subcontractor)
One -Stop Plumbing Services, Inc.
State License CFC1430061 SLC License
New General Contractor (or Subcontractor)
Reason for Change Wong contractor submitted
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 In rise as a result of this change of contractor/subcontractor or cancellation of
permit. a It ca6not be d If work has
been performed.
SIGNATU EOF ER rownedbu' er)
•S[G OF NEW GENERAL —CONTRACTOR
PRINT NAME
PRINTNAbE .��3Dn J�r%wrrr
State of Florida, County of St Lucie Comty
State of Florida, County a(St Lucie County
The following instrument was acknowledged before me this,
The following instrument was acknowledged before me this
_ day or .it ou ,20A!5,by�1&
28t1dayofOrtohAr ,262Q,by Jason James
is personally know to me
- who is personally know to me
or wh bas pmdu •tB;
or ho bas produced as m.
sigmtireoMmry Date
SIgnatQ ofN t ry Date
*Only signature required for change of
subcontractor Angelique Matthews
NOTARY PUBLIC
Revised 07/21/14
STATE OF FLORIDA
Tocilste-
CcmnW FF958412
Expires 2/812020