HomeMy WebLinkAboutCHANGE OF SUB CONTRACTORA
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
PLEASE SELECT ONE OF THE FOLLOWING:
`'ounty
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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 and signature. 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
co encing any work. There is a $50.00 fee for the Change of Contractor.
X CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT _ The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: Tc— 1 124 20 (8 Permit Number:
Site Address: ' p ON ; Ll l anion 91i'neS Mvc(,
ICr — 2 goyx r ai&,,. State LicenseilW I3c1ggq2SLC License
Original GC, subcontractor or owneribuilder
S(4.Af;6e_ G't_ State Licenseft 132.7208 SLC License
New GC, subcontrac r
Reason for
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contract subcontractor or ncellation of permit. A permit cannot biancelled if wo5k has, been pggfftmed.
XGIqATURE OFOWNER `orrownerfbuil er) SIGNA'ruKF.1,hNNJ;ZAL CO$TRACTOR �ar/a�ew/C.c-,� applicable)
PRINT NAME D wood PRINT NA.....- CJ)aW_WGSAt r10G C1`�
State of Florida, County of St Lucie County
The following instrument was acknowledged before me this
�6��d-a1y of 0 U� 20Lt by
kpQE % - - -- who is personally known to me
0 ohm prod cad )r (r Ce £' as ID.
Mal4 -zGa
Signature of Nota Date
t4pY PeA
Christian A. Pringle
ao srpd 09/15/1NOIafyPUliliC
State of Flodda
9�OF F��p My Commission Expires 04127119
Commission No. FF 224840
State of Florida, County of St. Lucie County
The following instrumept was acknpyvledged before me.this t,�
—day of BLCIW 20d by icc L1�ilI
who is pe� to
me rr o�haas oduged as ID.
Signature df Notary Date
�-
FOR. No4ry Pubkc State d Fbdda
=
ee GG23B823 y
r
PLANNING & DEVELOPMENT
BUILDING & ZONING DIVISIO
2300 VIRGINIA AVE
•MeIvIRNOW,ANNED FORT PIERCE, FL 34982
AUG 15 2018
BY (772) 462-1553 FAX 462-1578 Permitting Department
St. Lucie Count�i St. Lucie County, FL
CHANGE OF CONTRACTOR SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CIIANGE OF CONTRACTOR - Change of Contractor is to be signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
-L-CHANGE OF SUBCONTRACTOR - Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT - The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: i�- a-- I �
Permit Number: 0 d i - 0S-H
Site Address:.S5U r1 rnr/(t'4tn p;tte S g l uc) q- Pir ree /'� 3 1/95/
eywpp,, wo-�r State Licenset (t1.Z�'fJ/SLC License
Original GC, subAlontractor or ownedbuilder
McClendon Plumbing, Inc.
New GC, subcontractor
Reason for Cancellation
License CFC1427037 SLC License
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from
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 mince if work has been performed.
SIGNATURE OF OWNER (or own/er/buildeeer)L/ ),'t - S GNATURE GENERAL CONTRACTOR (ornew GC, as applicable)
PRINT NAME�f^W�i F/70&f . PRRJTNAME Kendric McClendon
State of Florida, County of St Lucie County
The following instrument was acknowledged before me this,
Oar dayof 9089S� •2019,by a 2s%Ir
P o h-Q,1-fn who is p a ly known to me
or who has produced as ID.
0.Q-0r�.a l�
Signature of Notary Date
State of Florida, County of St Lucie County
The f Mowing instmment was acknowledged before me this
day of fi1t Kn.lA5.�, 20� by Ih ✓(C.
m���QUU 011fl who is personally known to
me or who has pmduced Lr as ID.
Signature of Notary Date
Revised 09/15/].6 �" �""r' `�
g Notary Public State. Florida F494%
Nd ="Public State of Fbrlde
, Christina RobertsFF 210266
Grp pd� Fxphas 03716rt019 e My Commissiont2
y� Expires 0311612010
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION -
2300 VIRGINIA AVE RECEIVED
.FORT PIERCE, FL 34982 AUG 2 3 2018
BY (772) 462-1553 FAX 462-1578
St. Lucie County ST. Lucie County, Permitting
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERNUT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 19— 7-1 r
-Site Address:
Permit Number: . 16 -7— 05c
,41n 4er• 64"Ie",r- de",., &-&61, t State License SLC License
Original GC, subcon ractor or owner/b der
A State License, (RI WA SLC License
New GC, sultontractor
Reason for Cancellation
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.
S GN ''�WRw.1m 1n/erII .<IGNATURE GEERACONRACTOR (or new GC, aapplicble)
PRINT NAMEFO
PRINT NAME
State of Florida, County of St Lucie County
T--µ
h�efoollowing instrument was acknowledged before me this
r day off 2o1_S, by 1iQft.aE i
�ObPxh who is p orally kno to me
or who has produced as ID.
Signature of Notary Date
Revise 9
�4VN Notary Public State of BoNa
Christina Robe,ts
+A My Commission FF 21028E
pia Expires 03116*018
State of Florida, County of St Lucie County
The following instrument was acknowledged before me this
_day of 20— by
is personally known to
me or who has produced as ID.
Signature of Notary Date
DEVELOPMENT SERVICES
FORT PIERCE, FL 34982
(772)-46271553
FAX 462-1578
p PL'EASE SELECT ONE OF T11E1Ft7LLO*ING:
CHANGE OF CONTRACTOR — Change of Contractor istobe signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form -.-There is a $50.00 fee for the Change of'Sub-.,:.
Contractor. _ l
CANCELLATION OF PERMIT — The cancellation of a peiinit is acceptable only if no work has been done.
Cancellation of permit hNo.,be signed and, notarized by both the owrier and qualifier of record. There is no fee for .
cancellation of the permit. ) Date: �'a' i g L 7 Perm t Number: i CJ7 rO SXc,
Si2tte Address: /S�oti ga-,, pinks
K
� O Sre r L/C�'C, State License SLC License
Original GC, subcontractor or owner/builder
G • _14 4 h G le ejr11 Ca State License AIL 13 o I Li SiTLC License
New GC, subcontractor
Reason for Cancellation
E
Y.
The undersigned does hereby agree to indemnify and hold harmless St Lucia County, its officers, agents and employees,fron
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 c ncelled if work has been performed.
SIGNATURE OF OWNER
\ (or owner1/�buildder)I� SIGNA 0 R or new GC, as applicable)
PRINT NAME 4l0.CGt/GS/IT I'1,ylbCf PRINT NAME.��M✓1 ��•,"�
State of Florida, County of St Lucie County
The following instrument was acknowledged before me this
{r ` D day of R D��
20�, by It
Q[)bQ Ifs who is p zonally Im to me
or who has produced as ID.
Signature of Notary Date
Revised 0
Notary Puck state of Flatda
►/ Christine Roberts
A My Commleslan FF 210299
p tome 011612019
State of Florida, County of St Lucie County
e following instrument was aclmowledge�before rye this
�0 day of Q.L) q , 20�, by Ed'MT•1rt!
S W��Ny\ np4wr�ho is personally }crown to
roe or who has traduced I4L- as ID. _
EXPIRES: December Is, 2020
BondedThru Notary Public U^"'an'rtl�e!s
11
1,>
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE SCANNED
FORT PIERCE, FL 34982 6y
(772) 462-1553 FAX 462-1578 St. Lucie County
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERNrr
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR- Change of Contractor is to be signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR - Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form There is a $50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERNHT - The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 1,;If ;
Permit Number: 1 %07-CAS-29
Site Address: r .MLI �' M Piers t°J�thd, (29 - i�kfzlr� i6L c3LN93
— R (]Lhb (l C;" C2t4 M_ State License Cr2C IS�SLC License % 2
Original GC, subcontractor or owner/bfiildeg
License SLC License
New GC, subcontractor
Reason for
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees fron
costs, fees or damages arising from any and a0 claims of action for any reason, which may arise as a result of this change of
contr /subc n to . rcellation of permit.
A permit cannot be cancelled if work has been performed.
SI NA OF OWNER (or owner uII d''er) f/ SIGNATURE GENERAL CONTRACTOR (or new GC, as. applicable)
W
PRINT NAME A. "n
State of Florida, County of St. Lucie County
*�persmaallyknown
asaclat edbeforGa 'sCC••fSAr [o me
Date
� aN � "ENE M.2Xf
Revised 09/15/16 ,f' � Notary Public,STateofFlorlda
s 0�Commission No. GG 167382
My commission Expires 02/23122
State of Florida, County of St. Lucie County
The following instrument was aclatowledged before me this
_day of .20_ by
is personally (mown to
me or who has produced as ID.
Signature of Notary Date
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE LECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR - Change of Contractor is to be signed and notarized 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 and signature. 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. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR - Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a S50.00 fee for the Change of Sub -
Contractor.
CANCELLATION OF PERMIT - The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 6' 19-I0 Permit Number: 17U,)-GSrL
SiteAddresss:I� SSU (-t �p�/��GI.J�I I-it�S &J, �F pt�rce,fl
Aamscs ft6otrtJue-2. - Tr; 9 Lt ArthdioolStateLicenseCiZI<S10SI SLCLicense
Original GC, subcontractor or owner/builder
Lp.CweSnl 8664S - b'Q.otltt•4 Cplf"I@itateLicense 66C/•S.ZSFrSLCLicense
New GC, subcontractor
Reason for Cancellation Ra t
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, f� or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
con ac /subcontra br cea c lation oifp rmit. A permit cannot be cancelled if work h been performed.
S GNAIRE OF OWNER (or owner/builder) SIGNATURE GENERAL CONTRACTOR TOR(oR r new GC, as applicable)
PRINT NAMEC7Y/Ci V\�U VJ, PRINT NAMEJ:)0.r We— I r ryAlOe �S
State of Florida, County of St Lucie County
e lo%%ing!llliIjll uas acknowledged before me this
W d1V1420gby-1LLL��r; C.
U V Aho is personally known to me
or wh produced I .
Signature of Notary Date
State of Florida• County of St. Lucie County
The following instrument was acknowledged before me this
I"dayof - 1AAC- 20byfjJQ5Jrrt
Q01xyit ni who is crsonally kno to
me or wtto has produced as ID.
02--•-Repu I t7t, l o •
Signature of Notary Date
Revised 04/15/16
AUDPEY& HUMPHREY 'kk Now" Public State of Fla
4 '- MY COMMISSIGN 9 FF 17g772 Christina Robertsm
?,• • a?s EXPIRES; Merch 6, 2019 ` Mr Cemiulon FF 210265
Bf,„}k,• 9onded Thm NnmyPub7c Undemmters OF
Fxpirea 03116I201e
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