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HomeMy WebLinkAboutPARKER RESIDENCE PERMIT CANCELLATION of-- - -- PLANNING & DEVELOPMENT SERVICES I - � BUILDING & ZONING,DIVISION 2300 VIRGINIA AVE — — FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 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 far 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- Co ntrgstor. 7CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done. Cancellation of per it"is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the7erm�iitt, p 1 Date: I a Permit Number: 0© ? 0 �� Site Address: 13S borni nxon Lfi Ft A try. Pi State License SLC License Original GC,subcontractor or owner/builder State License SLC License_ New GC,subcontractor Reason for Cancellation C.h m 1 Mk. The undersigned does hereby agree to indemnify and hold harm) ss St Lucie County,its officers,agents and employees from all costs,fees or damages arising from any and all claims of action f any reason, vbi may arise as a result f his change of contractor/subcontractor or cancellation of permit. A permit can t be cancelle vor n perf Urn SIGNATURE OF OWNER(or owner/builder) Tof E ERALCON C /�(ornew C.as applicable PRINT NAME _ �ff bs 8r. 13 ..11 State of Florida,County of St.Lucie County ,Cou� of St.Lucie County The following instrument was acknowledged before me this The following instrument was a cknowtedged before me this _day of .20_,by _day of .20_,by who is personally known to n:.: J-r-1`7 who is Petsnnelly known to or who has produced as ID, nyc or wth//o has producedproduced as To. Signature of Notap Dote Slgnuture of Notary Date Revised 04/15/16 aP`µY!�•� Crl VNE wuroN r �IN COMMISSION#(300711it4 3r EXPIRES:May 14,2021 ��Fof Wo &vded llvu Budget Notary SBMws