HomeMy WebLinkAboutMisc Letters M1.F iF PLANNING & DEVELOPMENT SERVICES
�' "' - BUILDING & ZONING DIVISION
� RECEIVED
o 2300 VIRGINIA AVE
FORT PIERCE, FL 34982 C,r.r 16 2018
(772) 462-1553 FAX 462-1578
ST. Wc1p county, 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.
'"° 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.
Date: 10/12/18 Permit Number: 1703-0124
Site Address: 238 Bimini DR
Energized Electric State License EC13006279 SLC License
Original GC,subcontractor or owner/builder
State License SLC License
New GC,subcontractor
Reason for Cancellation New home owner
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
fists,fees or damages arising from any and all claims of action for any reason,which may an* a as a result of this change of
contractor/subcontractor or cancellation of permit.A permit cannot be cancelled if w as been p ormed.
SIGNATURE OF OWNER(or owner/builder) SIGNATURE GtNE TRA OR(or new GC,as applicable)
PRINT NAME 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 ollowmg'pst z e t was clm.owled a before me this
day of 20_,by day of 2011`R"by '�L(j�
who is personally known to me PIA kM,1,1,11ho is personally known to
or who has produced as ID. a ho has pr c as ID.
10/12/181 " 10/12/18
Signature of Notary Date Signa y re of Notary Date
ALYSSA BLACKSHEAR
Revised 09/15/16
4&
% State of Florida-Notary Public
a= �'
* Commission #GG 237887
My Commission Expires
���;°;;;°�� July 12, 2022