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Home My WebLink AboutCHANGE OF CONTRACTORPLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 SCANNED (772) 462-1553 FAX 462-1578 By St. Lucie County CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERNIT 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 PERAUT — 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: 2019 Permit Number: 1610-0131 Site Address' 6731 S. US Highway 1, Pon St Lucie, FL 34952 (Sprint Site ID: M190XSRRL) Chadle Craig and Associates, LLC State License CGC1521912 SLC License Original GC, subcontractor or owner/builder BlueStream Professional Services, LLC State License CGC1626974 SLC License New GC, subcontractor Reason for Cancellation Original contractor declined the work. 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 all claims of action for any reason, which may arise as a result of this change of contractor/subcont ctor or cancellado fpermit. A permit cannotbancelled if work has n p rcrlbudrformed. • �fJ�P SIGNATUR OF OWNER (or omder �Sli';'Ntt'>ii`fRE GENERAL ONTRAC R (oroew Gan app6able) PRINT NAME Michael Burkhead smic orFlorida, county of St. Lucie County The following instrument ww acknowledged before me this day of February 20to by Michael Burkhead who is personally known to me ,who sptoduced es to 2/5/19 gnaturc ofNom Date Revised 04/15RE eG21 PRINT NAME Stephen Saylor Smm orFloA" County afSL Lucie County mbc f flowing instrument was acknowledged before me this day of FMmr 20 19 by Stephen Saylor who is personallyknown to // me or who legs produced —as m. Signa of Notary Date V R:' ANGELA D. CERBANA` .� t. NonkyPtrs9e-Mivresc+a iMy C01aaIL561att ErplRa 1f31I2922 "'41 /"--1 PLANNING & DEVELOPMENT S BUILDING.& ZONING DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 I' •_ • �-•. • 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. 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. SCANNED BY Date: 809/19 St. Lucie County Permit Number: 1810-0131 Site Address' 8731 S. US Highway 1, Port St. Lucie, FL 34952 (Sprint Site ID: M190XSRRL) Concurrent Group, LLC / Fernando Manuel Munilla State License EC13008099 SLC License Original GC, subcontractor or owner/builder Goff Communications, Inc / Douglas L. Smith State License EC13004137 SLC License New GC, subcontractor Reason for Cancellation Original subcontractor declined the work. 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 f permit. A permit cannot bee celled has been performed. SIGNATURE OF OWN (or owner/builder STGNATUffGPNERAL C CT r (o�r new GC, as applicable) PRINT NAME Michael Surkhead PRINT NAME Stephen Saylor �LOGIO LL State of Florida, County of St. Lucie County State ofAonft County of£F.-EucieEoanty Th ollowing inst�fotl�pFnt* acknowledged before me this The following instrument was acknowledged before me this da of �°S� 20 to b J 1 day of 20 t_ by y � y�Pfl, 1Lf k°�td` tf� Michael Burkhead who is personamy known to me _ P nI;ylor -.a is ersonaa known to or o has producedX1'4 to. me 8119/19 / Siadatune of No Date Sig Revised 04/15/16 AUDREYB.HUMPHRV t9"�ry M'(COMMISS10%#GG390817 ! •` EXPIRES:Match8,2023 t� F ,P BW dlhmN,WyPUNCUndemwnters P y _as ID. 8/19/19 _.0 Date NOTMIy ¢ . 'Ueuc :9—t 2 AEG..75437W m O � E1(PIgFS t ��4 F1LTM OF�.••••