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Home My WebLink AboutCHANGE OF CONTRACTOR, &? PLANNING & DEVELOPMENT S'. BUILDING & ZONING DIVISION 2300 VERGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 AUG 2 7 2018 ST. Lucie County, Permitting CHANGE OF CONTRACTORi SUBCONTRACTOR OR CANCELI--i_13 ] egg PERIAT BY PLEASE SELECT ONF OF THE FOLLOWING: St. Lucie County _/ 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 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' August 17, 2018 1 Permit Number: Site Address: 6598 S US HM 1, Pon St Lude SLC 1712-0227 Bedrock Conshuchon Group, .LLC(Michael J. Wilson) State License CG61251494 SLC License Original GC, subcontractor or ownedbuilder Southport cmatrudlon Corporation (Robert W. Smith) State License cco-16.12872_ SLC License New GC, subcontractor Reason for Cancellation costs, fees or PRINT NAME Leo Leon Stave of Florida, County of St Lucia Counly claims of action for any, reason; which may arise as a result of thi! nit. A permit cannot be camce0 - rk has been performed. The following imaueowl was acknowledged betoreme this 179, dayot August .20 f_J by — Leo Leon wtw is personally known to me Ar wim rat pmducod win PRNMAME RobertWSmith Stave of Florid, , County of St Lucie County The following instrum®t was aetmowted before me this �� D +m day of 20 15 1, wl. cJr...,T , Personally known %fie is persoivolly known to hat produced as ID. l"I�11a e,,�'�ust t7, aols St uture ofNutsry Date 47�,�{•� ,�iY y O y ALISON E. FOSTER Revised 04/ %V $ o t W = 0,191'e-E NOTARY PUBLIC y��;0 -0 j 0 � STATE OF FIARIDA Comm#FF979779 mlres 5/2/2020 G r~ M COUNTY:. F L O R I D A St. Lucie County PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION RECEIVED 2300 VIRGINIA AVE FORT PIERCE, FL 34982 JUL 12 L J; g (772) 462-1553 FAX 462-1578 ST. Lucie County, Permitting CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT PLEA E 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 $50.00 fee for the Change of Sub - Contractor. CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: i Permit Number: -4r— 2 D z 2 Site Address: - S US �Vv�l —�:.�9 P �_ State License S I CA 9 C License Original GC, subcontractor or owner/builder S- 7 Flh1 pl urn hjn/4 .3n c_ State License CFG / ,241 N7 SLC Licensen6'7V New GC, sdbeontractor Reason for The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/subcontm for prcgln of permit. A permit cannot be ca ce0ed if workbeen performed. go s/L SIGNATURE OF OWNER (orowner/builder) SIGNATUgEGENERr)L9UNTRACTOR (or new GC, as applicable) PRINT NAME ifl)(hqel Wi 1 fan PRiNTISAME ACJIA{ f J/" State of Florida, County of St. Lucie County The llowing instrument was acknowledged before me this ,l�_day of� 201�, by -I lcy6Q LW &0 who is personally nave to me or h has produced as ID. Si atureaFN.m,y Date Revised 04/15/16 Jeam GmnW NOTARY PUBLIC STATE OF FLORIDA C mm# FF233787 ' v� Expifea 5#21=19 State of Florida, County of SL Lucie County The Vaming insumnrnt was acknowledged before me this 141 day of �irNQ ,201 r1 by MJc eel 9diertfd Sit- who is personally known to m,e,oppr who has produced as ID. Signature of Notary Date 4•`,',w",$iiq.••. LAURA F. REGISTER r 0 Commission # GG 064053 p= Expires January 16, 2021 :^"`Op;;,`,.x Bonded Thru Tmy Fuin lnsurence BOP38S70f9 05/31/2018 03:36 9545703391 SCANNED CORP PROP GFQIrICES PAGE 02/09 BY St. Lucie C6unty PLANNING & DEVELOPMENT SERVICES RECEIVED BUILDING & ZONING DIVISION junOO e1�n JUN 0 6 75111 2300 VIRGINIA AVE l '�c FORT .PIERCE, FL 34982 Q3NNf/�Q Pe miitting Count ent (772) 462-1553 FAX 462-1578 CHANGE OF CONTRACTOR. SUBCONTRACTPR OR CANCELLATION OF PERMT PI,F,A,SE SELECT' ONE OF THE FOLLOWING: x 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 PERMIT — The cancellation of a permit is acceptable only if no work bas 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: Ce LR lx' PerinitNumber: 1712-0227 Site Address: 6598 S US-1, Fort Pierce FL. 34982 Corporate Property Services, Inc State License CGC044277 SLC License Original GC, subcontractor or owner/builder Bedrock Construction State License C13C1251494 SLC License 304$2-- New GC, subcontractor Reason far Cancellation Bedrock Construction won final bid The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all costs, fees or damages rising from any and all claims of action for any reason, whit may arise as a result of this obaoge of r contractor/subcon� or or eaace11 t' ofpennit. A permit cannot be can lied work has becn peiPormeif. . , SIGNATURE OFOWNER'(or Amer •der) giGNA REO RA CO, (ornow rC. ap�applicable) PRINT 14AME__L0L0_Le Il PRINTNAME_ Michaeliilsc)4�—n iu�-'�bn MM COMMI5510N i FF 1390ES Slate ofFlonda, County of St. Lucia Coumy Stain ofFloddo, County of at. Luci (PIRESu¢: 2aM01c5es Fe me The tbllowng inffimrntwamowlcdgod be uAdUgB,IuNsats2rv7,6 fnllama' t rat was o2c0lo1� Ldayof S�dayo2091 -. / who is paaonolnlylmo tome w11)64 who is pm. anally kmovm to -or who s p�odu , s In. / I 1�/� c W has pfo dctd W. \ r " 4 �rp- /Y e Y r 5i u' N { ONFFF Signs reof otnry ntc * a FXPIR •AUAesl27_ 1S ,_