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Home My WebLink AboutCHANGE OF CONTRACTORRew9n f0ighange INS costs; ;fees; o%damages. a_result of this change a any and I clairsis: of action for." subcontractor or Feb 1816 08:13a Maurice Electric, Inc , 5617904642 i Ptanming�& Development.Services: Building &iCode'Regulations Division 2300 Virginia Ave. Fort Pleree, FL34982 (772WZ- t553. Fax 462-15TR CHANGE OF CONTRACTOR Or Subcontractor or Cancellation of Permit �CgNNE� �Wie Cn Change Of Contractor is to be completed by the property owner, and the new contractor of record for t current ptnuit A new permit application. must also be completed. with new contractor informatie signature, and.transt'erfee. A ceiv Notice of Commencement must be fled in the new contractor name for job values greater than 'S2,500 (S7,500 if A/C Change -out). A recorded copy must I submitted prior. to commencing any work. Subcontractor changes can be completed by the gener 'contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both tl owner and qualifier of record. d� 61 Hate: Permit Number: �S �' 7 Q;, - L 16;� TN L let General /Co�nttractor (or Su6contracror) State License SLC License i U Fa�ii lli✓` q - u/ C S ate License=l SLC License New. General Contractor (or Subcontractor) ,itea'sori for Change NA W 4 ., uu 'agents, pernn rp 7. %SIM TUVQ fined does herebv agree to mdemntty and hold harmless St. Lucie County, its officers, employees from all costs, feet or damages arising from any and all claims of action for v hich may arise as a result of this change of contractorlsubcontractor or cancellation of P, - nao[ be cancelled if work has bun performed, SfneorF7oridq CouhH of St. l.meCsamn ....... Toe folbxinedisewnm xwncfmo-aiedgedhr,brc mc:tus . f( iL�uAo ispewiul\•kmrH•iu me . 'ar lnsraodxM�_t�,t�_yt 1p. .. ,SGONuRefNararr ps •SfGKA-�� ONIRACTO. NaL�TnAade�Gt.tArl Q parir Sate efFlorida, CounroorS� L,:eie C"off• the f>Ihuing imtrmn.nt uysaclTo,rtNr� hruremrrh:s .rub has psoducetl as 1D, mm frhtl� aJlBjl�a S'ry%nalare of\wry Hatt ' On E,y._sS'gnature'-tequ;red-for change or subcontractor ' rP-VLicd 07/21/14 .. few "' !+�� ,+�"pyu,•,,•, HUIMR NICHOLS ,4' SrEPnANIE aEEVF: p� " MY DOWSSION 4 FF ROM Watuy Puouc. sute of Ftond� EXPIRES: October 2U. 31t8 . EVlres Jen 5. 20Ig - ?'fi r BondudTntu Nelarf Nbk Urzk wg,, �Y W". Planning & Development Services Building & Code Regulations Division 2300 Pngink Ave. Fort Pierce, FL 34982 (772)462-1553 Fax 462-1578 CHANGE OF CONTRACTOR Or Subcontractor or Cancellation of Permit 2 5 2016 ' Sc�NNE Sg �,JCieCny�Ot, 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: Permit Number: Site Address: �� f 1 State License' SLC License Orrigin_al �Geenerral Contractor (or Subcontractor) ,D4a 4am wAaes r �aUG 1�• M (6 tw Are-, t 0 L State License cAwl-1 olot{ SLC License a ► 1 ►�.a1L 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 Teasoa which may arise as a result of this change of contractousubcontractor or cancellation of penni wit cannot be cancelled it work has been perfo SIGN +' (or owcerfbuUtler) SIG REoF NEw 03d FASI-0R — &47CoY,1✓0,66 PAICIT /NF.ME /Ol�l 1f A � �lJl�i� PRINTNAIdE t�- �--�+� � r+NOW- Stste of Florida, Cowry ofFt-I:neie8ameyY'a I`l �e�S� The fall ing inshumeotw ael„awledgedbefbxmep 2 aayaf feb� zd£ by �JUt7nl+, k m&o i&=io,aly Imawta ma orwho has produced 6igeatawofNotar7 Date 8rateofFlorida. Countyof tiacieEweµ7 P*.ya., &AC0 adwowledged before methis 20ti by MaAt4G i tame as 11). , Date *only signature raquired for change of subcontractor aaviaed 07/21/14 !"' ERANGA A. DIAS ,+i,"pr''d�,.,=P,,,KAYGREESON GREE90N Notary Feo9o-State a Flodda . �n�:Slate of Florida•e Commission I EE-219765 '• i •res Doc 29, 2018,. My Comm. Expire, Jul 26.2016 % j i FF 157468'X",,,, 'aBoaal Notary Assn. a 'd O"Z'ON Wsl 91fi'sZ'gaj RECEI'.7D 092016 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 r�.. t.• 4_- I 1 FEB - 9 2016 SCANNED By St. Luce 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: a-g-IG Site Address: Permit Number: S/-,C- I E_6 `7 - 63 Vr I f- f � I . 1_ vrC 3� lke; e Pat. 1 —Sae cx u 1 V� 3v� p & KS Jh c— State License SLC License C63C O (DO 5/73 Original Gener ontractor (or Subcontractor) (or Subcontractor) Reason for Change License 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 has been performed. SIGNATURE OF OWNER (or owner/builder) PRINT NAME I t't.oV1rl�S /'h 9A—\D C-Q Ct� C�KT rZ�' ✓`I-aVvi 1h •� Y Z- Y State of Florida, County of St. Lucie County �Thwng trumentwas acknowledged beforeme this f -(YU, 2016 by i homM A' PAC bc,ocy— who is personalty know to me %,,he has produced FL_ br,vev(icas in Signature of Notary Date Y _ • SIGNATUP60F NEW GENERAL CONTRACTOR PRINTNAME J�EjAa J 9"=E State of Florida, County of St. Lucie County The Nowing ivs eat was acknowledged befo4e me day of zFA , 20& by ,' lelce is PersD. i}�o� I3L —Fas EB 0 9 2016 Date *Only signature required for change of SubcontractorRZ& NA DANDRIDGE blic - Slate of FloridaRevised 07/21/14WEXPIRES gg RRO . Expires Aug 3 2016sion # EE 187876681000 2017ugh National Nalary Assn. coat