HomeMy WebLinkAboutCHANGE OF CONTRACTOR4 so,OD
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
/70(c, - ()(-s1
8GANNE®
BY
St. Lucie Count,
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 flied 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: U)
Site Address:
Auqa Dimenslons Plumbing State License CF665726 SLC License 18628
Original General Contractor (or Subcontractor)
One -Stop Plumbing Services, Inc. State License CFC1430061 SLC License
New General Contractor (or Subcontractor)
Reason for Change avrong cantractor submitted
The undersigned does hereby agree to indemnify and hold harmless St. Lucie Couny, its officers,
agents, and employees from all costs, fees, or damages arising from any and all claims of action for
any reason, yyhich may an -as� It of this changeofcontractor/subcontractor or cancellation of
permit. a it ca celled if work has been performed.
PRINT
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
a day of a�• , 20B byQ,
.SlLuw.O 4951minersonally know to me
orw obas pr as ID.
Signature of Notary Da e i
• S i OF—NEE-W GENERAL CONTRACTOR
PRINT NAME 7TC5>-1i J,4411r
State of Florida, County of St, Lucie County
The following instrument was acknowledged before me this
28thdayofOrtnhPr .2oMby Jason James
who is personally know to me
or ho bas produced as 11).
Signa r afN t ry Data
"Only signature required for change of subcontractor
Revised 07/21/14
Angeliquo Matthews
VNOTARY PUBLIC
ESTATE OF FLORIDA
a C.Mra FF95a412
•SwcE v0 Expires 21812020