HomeMy WebLinkAboutCHANGE OF CONTRACTORPlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
RECEN'D APR 112016
Or Subcontractor or Cancellation of Permit
SCANNED
BY
Si. 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 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: 3/25/2016
Site Address: 6630 S. US Hwy 1, Port St. Lucie, FL 34952
Great Dane Petroleum Contractors Inc
Original General Contractor (or Subcontractor)
Permit Number: 1501-0413
State License SLC License
Mulligan Constructors Inc. State License CGC1510462 SLC License
New General Contractor (or Subcontractor)
Reason for Change A ine i— C,Aa md Pt l � �LvauZ�cr✓
The undersigned does hereby agree to indemnify and hold harmless St. Lucie County, its officers,
agents, an employees from all costs, fees, or damages arising from any and all claims of action for
any reaso , which may arise as a result of this change of contractor/subcontractor or cancellation of
permit. A ermit cannot be cancelled if work has been performed.
SIGNATURE OF 07INER (or owner/builder) ' MlykTURE OF N GENERAL CONTRACTOR
PRINT NAME gi J._ P TNAMEJaSon Mulligan
State of�,CCounty of St. 61eiecetettq FW,4 jle—
The following instrument was acknowled ed before me this
da, of&QV� ,20Aby
1 who is monally know to me
�rj"hp has produced as D)
1 //) 'n ti �i'1 3�3D to
tgnature of Notary Date
*Only
Revised 07/21/14
of
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
'PrAday of AY-Ok 20]_(p, by a OYN
Mul\i q C," — who is personally know to me
or who has
Date
JENNIE BACH
MY COMMISSION ® FF 0158B7
EXPIRES: July 5, 2017
Boed,dThat Notary Pubfn Ur&W11ora
JIMIG V,
Commission Expires August 16, 201