HomeMy WebLinkAboutCHANGE OF CONTRACTORD
L
' F PLANNING &=DEVELOPMENT SERVICES}'.
_ - -_BUILDING & ZONING DIVISION
a ry 2300 VIRGINIA AVE _
_ FORT PIERCE, FL 34982.= 0 .`
71, (772j 4624551FAX 4621578 .
CHANGE OF -CONTRACTOR SUBCONTRACTOR' UR CANCELLATION ORPERMT .J
C
I A L PLEASE SELF O�1EAF THE FOLLOWING? + C `
' -- , CHANGE OF CONTRACTOR Cfiarige of Contractor is'to tie signed aiid notarized by the ptoperty'owrier
and!the new,c9ntra4.r of r�ord for the curredt permit.'A xew permit• application must also be eompteted With new,,- ,
'contractor mformatlon and signature_ A new Notice of,Commencemenf, musube fdediin the:new contractors; name-�
for job values greater ttfsrt $2,500 `($7,500 .if A/C Change -out). A recorded ,copy ;must .be' submitted prior. to
commepeing any,work There is a $50 00 fec for the Clesnge of Contractor: U Y
' L CHANGE OF'SUBCONTRAtTOR Subcontractor changes are to be completed by the general contractoi,-,
The hew subcontractor. must fill out a Subcontractor Agrcemgnt Form: There is a,$50.00 fee for the Change of_Su
t o
Coofractor,o
� "`=" CANCELLATION OF PERMIT - The cancellation of a permit is acceptable only, if no'work hai been done, I
- Cancellation of permit is to be -signed and notariied�by both the owner`and qualifier of record There is no fix i;r:
CFncellntioti of the pe miE — _ `•- ` l f r Lr
_ C.1 t�; •" °` " 1812-0i75', Date % r� _-_ PermttNumberr,-
u t
6598 US 0 1 Port St Lude, FL,
Site Address:, _a rJ
Twist All Electrical Services LLC __ 'EC13MS056 ,
State License SLC License
wnh Original GGaubacZoror owner/builder ` `
" t F Stwe's Electric of Sotto Flondii_ �.-' , . -_ StateLicense: , SLC_gicepse � `= �-
- New GC subcontractor
Reason for 6ricellatwns—
t
The undersigned does hereby agree to indemnify and hold harmlessSt Lucie,County, its officers; agents and emptoYees from alt t;`a
^ costs, fees or damages arising from any and all claims'of action for any reason;,which may'tt isc its a result of this change of V _
'tovlractor/sebcontractor or canceiletionof permit. A�permit cannot be canoe Ed f work has beea,performed
SIGNATUREO OWNER(orownerlbuilder). 1- _ ^SIG1jATU GEN.RALCOIYIRACiOR (or new GC, os apptiabk): `
ILi J
] _ Robert W: Smith',
_ PRINT NAME-� 9 -- '- i._ r _ PR1Nt:NAME.
J
� :3
'' State oCFlmuta. CauntyofSt. Lucie Coumy State ofFlodda,f.amty of St Lrsie CotrmtY i , �'- a F,
,. The Mewing msaumiet was Ubmtedged befoiameThe Mulneat
this_. -kOT�dmCwmned bre mts
0 2Uby
202
- . ,) j who ispetsmmlt bwwn to mc.. L'. RotrertW Smith r t wiw. is persormnylmmm to.
I
7 or Wdw hasp 'roducod_) as m ._ r 'orwbo has prod.' as m ... Z� ry
r Olyr
A r SrgeiNre p(Notary 7 'J- �ANNEDI"1 •; , natc .�
r. x _. BY ' tJ l i
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iiavia a oaits>ia i i' JOA kEMBUDASH -
J St: Lucre
my COMMISSION K 0(i058321
E7CPIRESDecamber2T,2020
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