HomeMy WebLinkAboutMisc Letters2017-02-16 16:55 j.a.taylor roofing 772.468 8397 >>
'i
r� � PLANNING & DEVELOPMENT SERVICES
+ = = BUILDING & ZONING DIVISION'
. 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
PI.,EASE SELECT _ONE _Ol; THE F01A.0Wi
P 1/1
`_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 information and signature. A new Notice of Commencement must be f led in the new contractor's name
foe• 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. I
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 $50100 fee for the Change of Sub -
Cont tor,
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 the owner and qualifier, of record. There is no fee for
cancellation of the permit. I
Date: — l % Permit Number: A
Z504 —
Site Address:
State License I SLC License
Original GC, subcontractor or owner/buiIder
,j
State License I Sf C License
New GC, subcontractor
Reason for Cancellation I/U t)T jt�_. LUGS �15J C AJC C
The: undersigned does hereby agree to indemnify and hold harmless St Lucie C its.. fice'rs, agents and employees from
costs, fees or damages arising from any and all claims of action for any rea lick m y aris�c as a result of this change of
contractor/subcontractor or cancellation of permit. A permit canno aneelled if wa I fin%J been performed.
SIGNATURE OF OWNER (or owner/builder) SIGNATURL GENERAL�CO�VAC I;OIt,(pr acv ,C, as applicable)
PRINT NAME
State of'Floddo, County of St. Ludic: County
'nu following instrument was ucknow►cdscd before nit: this
day of'—, 20—, by \\����tt111ili1fJl1///��
who is personully kt�tt ttl•��N MAlV9 �i,,
or who has produced us 1D. ~ iy( pp Do<1,"
z 7e
04
,n
Siguttture of Notary Date
.y � ..
�6rAG'•Ab�'So p;: • •n
Revised 04/15/16 '1TE
��1101\`0\�
PRIN'rNAME 1 YL
State of 17ondtt, County ol'St. Lucie Ci unty
'rhe loliowing' tat none was a nowted(ted 1•or me hi
day ol'U 1� I1Y�C
__ who tti, +�_er�`nnnllyknown to
t or who erode Cd ux ID.
'�'I_ tture of Notary Date