HomeMy WebLinkAboutMisc Letters PLANNING&;DEVELOPMENT SERVICES
BUILDING.& ZONING DIVISION
i 2300 VIRGINIA:AVE
FORT PIERCE, FL 34982
(772)462-1553_ FAX 462.4578
CHANGE.OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—.Change of Contractor is to he signed and notadzed.by the property owner,
and the new contractor of record for.the current permit:.Anew permit application must also.be completed with,new
contractor-.information and.signature. Anew Notice of Commencement must.be filed in the new contractor's name
for job. values greater than $2;500 '{$,7,500 if AIC Change-out). A recorded copy must" be submitted prior to
commencing any work.There is a$50.0.0 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.
)M 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'tlie owner and qualifier.of record: There is no feefor
cancellation of the permit.
Date: 5i177jT. Permit Number: '1705-0166*572
Site Address:)00(
Miranda-Plumbing&Air.Conditioning State License CACI 815486 SLC License
Original,.GC subcontractor or"owner/fuilder
State License SLC License
New GC,subcontractor
Reason for Cancellation customer not moving;foward with ac replacement.
The undersigned does hereby agree.to'indemnify'and holdhaiinless St Lucie County,It..officers agents and=employeesfirom all,
costs;fees or damages-arising from any and all claims of action for any reason,which may arise as.A resalt of this change of
con ctor or cancellation of per ' . rmit-cannot he cancelled Wwork has been performed.
SIGNATURE OF OWNER(or owrier/buildefii) SIGNATURE GENERAL CONTRACTOR,(or new GC,as applicable)
PRI,NT NAMIij- 3, �( )Cid ? PRINTNAME
State of Florida,County of St Lucie County State of Florida,County of St.Lucre County
owing Insirunteat was acknowledged before rrittbs.gg i� The following i istrunient was acknowledged before me this
ay of .a 20bY _11✓1 i � day of 20_,-by_
tvho is eis all laio `tome who is personally known to.
P Y. ... P- Y
or has produced ID. ine or who has.produced as.ID.
44 4
! T�
tSigNuoary Date Signature of Notary Date;
'Revs > f� 16 NiCGfrllil�CMaholi
COMM19160 #. FF945187
Ewes:Wember 19,2019`
Bonded thru Aaron.NotW