HomeMy WebLinkAboutMisc Letters Sep 09 2015 12: 23PM H-R-,,LRSERJET FAX p. 2
Planning&Development Services REcElVpo
Building& Code Regulations Division
MO Virginia Ave.
0 F! 1 0 Fort Pierce,FL 34982 SEP 9 2015
(772)462-1553 Fax 462,1578
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CHANGE OF CONTRACTOR
Or subcontractor or cancellation of permit
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 new contractor information,
signature, and transfer fee. A new Notice of commencement-must be:filed in the new contractor's
name for job value's greater than $2,500 ($7,1500 if A/C Change-out). A recorded copy must be
submitted prior to commencing any work. Subcontractor changes can be completed by the.general
contractor. Any cancellation of permit must be executed by the owner or qualifier-of record.
Date: A5 Permit Number: C—
Site Address: Oc-a-,tJ)�)
Ke c-r- 41
i,osCdv4 A,. -C,,xo,,,(7,nZ±,fg_State LicensecGC151A(,z7SLC License
Onigimal 6encral Contractor(or Subcorkractor)
State License SLC License
New General Contractor(or Subcontractor) AkVY"-- pas"q,
coxce)
ReasomfbrChazige oerm
The wildersigned does hereby agree to indemnifyand hold harmless St.Lucie County,its officers, je15.-g (301'q
agents,and employees from all costs,fees,or damages arising from anyand all claims of action for
any reason,which may arise as a result of this change of contractor/subcontractor or cancellation of
permit
�AURE�MW�MiE��CONT�MR�
OWNER (or am�ex/b�dder) *r'sIGYNATM OF NEW GFNERAL
Mop
�G,�ATM OF
PRINT NAME PRNTNAW
state of Florida,County of St Lucie County State of Florida;Courcy of St.Lucie County
nefolloving, trwrent was aclmowdodj�d tcfore roe this The following in+wwm vt8s admawledged before me this
21Z&,—S =211
--2N by_ Of by
who is;:6;onaily�a�to M'D A- Who personally kuoo to me
o 1 wh has produced o9wbo has produced as 0 P u0c as _J ID.
sip"Ure of NAWY Date Signature of Notary Date
KAREN J MARTIN
N
11AR
KAREN J PA:ARTIN
qm:
*Only sign a qvicamm�m="atmos subcontractor,
&JY COMMSSION EE18720-
EXPIRM April 05,20% 9(15, 16
EXPIRES April 05,:2D16
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