HomeMy WebLinkAboutMisc Letters ;• - l�. Y rt•.. . � ;�,,;r PLANNING &DEVELOPMENT SERVICES
' BUILDING & ZONING DIVISION
2300 VIRGINIA,.AVE
MIM
�....____........ .._.__......,,.., FORT PIERCE,FL 34982'
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PEST
PLEASE SELECT 0M,OF THE OLL0MVG:
CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized 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 infomaation and signature_ A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to
commencing any work.There is a$50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be signed by the general contractor only.
The new ubeontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subco actor.There is a$50.00 fee for the Change of Sub-Contractor.
CANCELLATION OF PERMIT The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be sighed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the perlmit.
Date: Permit Number: 1105--Q15,1511.)
Site Address:
ryi.4
State Licens �LC Licensed
Original GC,subcontractor owner/builder.
hN State License SLC License,._
New GC,subcontractor or owner/builder
Reason for Cancellation iv�_ UAL 3UL_"St ' nc,ki, M- Ww
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all VL
costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result ofthis change of
conrtractor/subcont actor or cancellation of permit.A permit cannot be cancelled if work has been performed.
V",
SIGNATURE OF OWNER(`or dwner/buildcr) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable)
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State of Florida,County of St,Lucie County State of Florida,County of St.Lucie County
Ifollowing in trument was acknowledged before me this The following instrument was acknowledged before me this
Ijday of,-1 i`�' 20_d,by,� day of 20, by
why o is personally known to m wha is personally known to
Awqho hasrodueed _ as @, me or who has producedas ID.
Signatarc of iVotnty Date fifty
DANELLE M WESEMAN E C E I'Vff E
`" My COMMISSION#FF961469 ir_
Revised 05/18/2017 EXPIRES Febmaty 16,2020
JUN / 72017 '
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