HomeMy WebLinkAboutChange of Contractor 7'ROM :cast electric .
FAX NO. :7725699775 Jun. 22 2016 1:47PM P1
PLANNING&UVELpiPM N1' SERVICES
BUILDING& ZO NING.D►NISION
s 2300 VMGINIA AVE
FORT prERCE,FL 34912
(,772)462-1553 FAX 462_1 S'75 tj Ckv�
CR Ole C N .
Bc r IC OF A
E Q� -FULL i the so r1wner.
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C1f�fAN� aF`0�11�'IRACTOR Change itCgn e ar r,4108.ttoust a1P ,6e omplet d with. new
Pe
and the new cmtractor of record fcir tha aut'reat in t bs auhCtiva3 prior to
A new I�aiice of Garnmenrz;nar>E rraus�t be filea;Ief tie new ccmte'act�'s n�:mR
contra.cstorsnforrnatirsn ad=S2 SW ($7,500 if A./C ChanE£�ut) � reccraed ��
for job values gs
0(1 fee for team Gbtalygt ut Cotwtras r.
ppenfie rn8 �watk.'>C'1tNete is s Q. � be completed by f:-103. -contractor.
ommeCHANGE o, SL'�ONIRACTOR—Subcontractor clean-W61 re is a SS0.1lf1 fee for ttse Chstige Of Sul"
The new subccntrRcl:o-trust 11l out a Subcasntr,,cwT Agement ForM,
C.oatrar r. :t;i a+ccwAble Only no wcark icy'liceaa dant.
S'Pea a ebtgrizxd by bath the tywner wid quIlifier of, ;ccorci.Thezp is qua f-c for
Cr C+CLLLATION OF P�I�MTT—7 h e caz ctlllatiatt of a p
sctcaltation of per-nit is to be P C✓
captartat[on Of W p6rwtait
.� Permit Njiviber: —
Date,
Site n 1, L.icenab
OC aubccsntxsotor or ow�erlbuildm SLC 'nse,�. ..._--�----
New GC,su17CG1nt ego �1 f, frA _tl 'ic,'w►v
c1liptoym from
Reason for Carceilado11 a ...- WV iia oi�ters. of this chatkee of
tv tnd+�nnlfY old hold harxnlass St Luck G �+�y azist a result
The undersign docs horol~�� ,and al',s;,aicns of action for any rQUIDw Such
;,oats,fees or Sat agog arisi71$ Yrcla A permit eta>u�be cawmltw if work has bsea pRrloraaecl.
conut+�r���Onrractur ancellation of pe
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Sir,TirlTU&SOF 0 `FSt(OK b 1C
pRYNT J►t s� ,l— C/'/►' Stsln c£FlOzid�Co�►tY of 9t tu6a Campy
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t 9hSntlTn x W"wCiK1CV'Wga M nX INS
$mac or Florida,c6w of St Lucio�'t' The fo
em,Acd�d/ before tax Ilia --*y of — 20—by------
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