HomeMy WebLinkAboutRevisions 21001
08/30/2015 21:06 FAX
Yf'i �• t yrn
Planning&Development Services
B€anding& Code Regal.-tions Division
� ' s 2300 Virginia Ave.
{{ T art y Fort Fierce,F1,34932
(772)462-1553 g'a%462,1578
CHANGE OF CONTRACTOR
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 now contractor information,
signature, and transfer i'e€a. A new Notice of Commencement insist be filed In the new contractor's
name Voir job values greaten Man $2,500 ($7,500 if tai/C: Change-out). A recorded copy must be
submitted priori 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.
t i
�6ate `>' ( _ Permit Number., )IS-c-
Si ,eeso 1': 7L a 'J}7 ,
,_ "�: SLC License
—,rl y f t;t ufa ULI State LicenseCL.4� t 2?L •a� —�----
3 �_4 �...`Y � � �
Original General Contractor(or Subcontractor)
f�f State License SLC License:
Nevv General Contractor(or Subcontractor)
Reason for Change,� �'�_�
The undersigned does hero'by agree to indemnify and hold harmless St.Lucie County, its officers,
agents, Ind etrlploye(,-s from all costs, fees,or damages arising from any and al{claims of action for
any reason,which may arise as a result of this change of contractor/subcontractor or cancellation of
pe rr;ait A pelma ,� �a� t be c�a ce11 d n work is Wispbeenperformed.
SIGN,k TURL OF Ott!vrSIGNATL'RB OF NEW GENERAL CONTRACTOR
P12ii`%
State of Florida,County of St.Lucie Cowity State of Florida,County of St.Lucie County
The followin`instrument-ems ukriowledred before the this The following instrument was acLnovvicd rd before me this
~mdayof "'='r 201,) ,by ._.___ _.___—day of_ � 20._.._ `iy._.__ _ —
i i(w�t...� ';���+ y ��1,•; �1110 is personahy}snow to me who is personally know to me
or ivin has,•,r9duced as ID. or who has produced as M.
Sagnautire cf Notary Date Signature of Not=ary Date
'kOn_�% signature tat r _� rte: � �S1�fJCO?{ COOL
JOFlatlhlE FELIX
RFvS.soci 07/2.1/4Motar
�:, r i'uvlic•StzYa at Florida
Oot,im.Expires Feb 28,2017
mission e,
Com E£8790'48