HomeMy WebLinkAboutCHANGE OF SUBCONTRACTORX,
�:-PLANNING &'DEVELOP ENTSER-
BUILDING &Z0NING;bIVIS'I0N
71ECEIVED,�-.
2300 VIRGIN A, AVE'
JAN
E'FL 34982 F0 T PIERC
(772)'461-t553,,FAX 462578
s P.'Lucie County,
CHANGE:6iFCONTRACTOR. SUB!Q!!2tCANCELLATION4FQROROVPERW
Is
E SELECTONE OR THE FOLLOW MG.
i
CHANGE OF CONTRACTOR -Change orC6ntmctor'ii to be signed owner,_and notarized by ilic property owner,
',aWthi new contractor of record forthe current p K new permit`application Must also be completed with new
conimcior,information and sigifiiturc., A new Notice of Commencement must be. filed in the new coniract",Is name
for job values greater than 52,50o (v,5oo ir Atc Chang&dut)� A recorded copy must be submitted prior to,
commencing any work. There IS -2 $50.00 fee ror the Change or&triaclor.
%'X CHANGE OF SUBCONTRACTOR Subcontractor changes are to be completed by the' general
contimor., The new subcontractor must Fill oil a, Subcootractor'A6rccmcni Form.L Them Is a S50.00 fee for. die,
Change or Sub -Contractor.
CANCELLATION OFIPERMIT The cancellation of a permit —i s acceptable only if no work has'been
d'anc, 6ancellation or piirmif is,to'bc signed, and nolarfied by both the owner and qualifier of record. There Is no
'fee for cancell intloti or the permit.
SCANNa:,
1/16120 %
Date. Permit Number: 19HO370 ,
St LU ripOnn6tir
'
Site Address: itim Cobbile'stonebir
7,
TUTkay COASMtlon Pta"unim Inc t State Licjosi PRC1327066 $LCLiceasc
Original GC, subcomroctor or owncribluilder,
License CCC1330653 SLC License
'N6 YIGC; Wb ' comraE I to I r�-
�
Reason for Can=1146A,!!
The ondersigned does hmby ugrec to indemnify and hold hamilm St Lu66,CZniy,ils officers, agents and LeMpleli&M from 611
costs, fees or'damages arising from any and all cl�i
to
as a result of this alms rlWYm350n.WfiiCho13Y2fiSC change or
of
con1kracto'6iiibcontracterer;ancciationorperinfLApermit csnno t be ad I ark s been performed.
SIGNATUR11,01701VNER (uru%mTleikler) SIGNATLI"NE CT0R(=!CWGC. a awlzr*lcl
PRINT MANS PRWNAMC-18=nay'
affl.uh� Counly arse LSiwCatsuy
The ftillowung inonumat wo xLzmwk%kcd!G0w miles T zLwwk4vdbcf6=M-lhi5
ful"Q msuivam
6, gayor —za-!L;by_:�
is by
143Y 6�7 —7�1
:Wtio is Pe ley i6" lo*loiBran Maloney Whow
ftmaut McColl ate slKnatu-!rd , italry-
7
Revised C
ffof R
IFFWU
8"MF&2?.2m
:mF*=y2.Mo
- A