HomeMy WebLinkAboutMiscellanious Letter PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982 RECEIVED
(772) 462-1553 FAX.462-1578 JUN 191010
Permitting Department
St. Lucie County
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
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 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 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.
CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
Cance lation 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.
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Date: 0/ Permit Number:. 1-7/
Site Address: (O
State License SLC License
Original GC,subcontractor or owner/builder
State License SLC License
New GC,subcontractor
Reason for Cancellation T�kQ
The un ersigne does hereby agree to indemnify and hold harmless St ucie County,its officers,agents and employees from all
sts,fees o ama arising. any and all claims of action for any reason,which may arise as a result of this change of
contractor/s on for c llation of permit.A permit cannot be cancelled if work has been performed.
OWNER(or owneribuildder) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable)
PRI - NAME (�� l0.S 6JQA PRINT NAME
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this The following instrument was acknowledged before me this
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who is personally known to me who is personally]mown to
who has produced as ID. me or who has produced as ID.
ignature of Notary Date Signature of Notary Date
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Revised 04/15/16 t: ;a �4� Notary Public-State of Florida
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COMMISSion#FF 177249
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