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HomeMy WebLinkAboutChange of Contractor PLANNING & DEVELOPMENT SERVICES BUILDING & ZONING DIVISION � RECEIVE® � 2300 VIRGINIA AVE D @ ---- - FORT PIERCE, FL 34982 JUN 2 2 2018 (772) 462-1553 FAX 462-1578 ST. Lucie county, i'crmi Permitting 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. 2814"`© CANCEL,L,ATION 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. Date: Z'�— F Permit Number: 1802-0423 Site Address: 2614 Newport Dr Fort Pierce,FI 34982 Florida Retrofits,Inc. State License ICC1330830ICBC1259131 SLC License Original GC,subcontractor or owner/builder n/a State License SLC License New GC,subcontractor Reason for Cancellation Duplicate permit The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers,agents and employees from all costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result of this change of contractor/subcontractor or cancellation oJffpp/!elpit.A permit cannot be cancelled if work has been performed. all_ SIGNATOR OWNER(car owner/builder) SIGNATURF,,6ENERAL CONTRACTOR(or new GC,as applicable) PRINT NAME / '��`'> ��aj v PRINT NAME James Cody Thomas Q �rarcJ State of Florida,County of St_Luciere my State of Florida,County o€S4,-lueie�ernity The following instrument was acknowledged before me this The following instrument was acknowledged before me this 1a day of�June 20f 14 day of June 20 18 by by- AJes Cody Thomas who is personally known to me who iss 0erson to v 1 has producedi�GOL as ID. w to i prod as ID. —/q-11-- V — / Signature of Notary Date Signature of Notary Date Re iso Pq ,�s� AROPI LISA pLp,NKENSNIP Eno HARON LISA 13LANKENSHIP:;' MY COMMISSION#FF1 2p18MY COMMISSION#FF153833�i "' EXPIRES August 24, 201 B�uFF�6 XPIRES August 24,Service.com(407)390.0153 Floridallotary FloridallotaryService.Com