HomeMy WebLinkAboutMisc Letters 09-03-18;20;59 ;From: To:7724621578 ;7724618722 # 2/ 2
PLANNING &DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION _ RECEIVED _
• 2300 VIRGINIA AVE
4 �
FORT FIERCE, FL 34982 SEP 0 5 2098
(772) 462-1553 FAX 462.1578 ST. Lucie county, Permitting
CHANGE OF CONTRACTOR2 SUBCQNTRACTOR_OR CANCELLATION OF FERMT
PLEA_SE SELECT ONE rafi'1"HE FOLLOaWING:
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$58.00 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.
Irate: 1 a�'(` Permit Number: M Ot- tit p ri
Site Address: .SS19. 1 SXAJA_�0euV-U C Wd z
�^�1c nrL State License A__bt`StR 4-11. SLC License
Original CC,subcontractor or ownerlbuilder
St.ite License SL,C license
New GC,subcontractor
Beason for Cancellation �'=Vwey jrQca tj -1_V_tfi±Q���Cly c�
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
contmetor'/su Contractor or cancellation of permit.A permit cannot be cancelled if/work has been performed.
SIGNATURE Or OWNER(or owner/builder) SI ATURE GENeRAL CONTRACTOR(or new GC,as applicable)
PRINT -� PRINTNAMEl
State or Florida,County of SL Lucie County State of Florida,County of St Lucie County
The following instrument was acknowledged before me this rho YR.
Inst ment wav ac�j Wedged h�re me this
, yofGGP9� .20( by/t'lirl��►r_ dn
:9e'AZti& who is FcrsorJ<]sown to me ��,E^�/11�'1" who is personally known to
of who produce as I[7, me or o has product as ID,
.�-�.--•�—....._ � /cf'r�
Slgnatur SiAnnture of Notary Date
SUSAN MONTENEGRO �.v�rPi
J . . MYCOMM1551QN#GGO$9099' ,+,.•,k; Sl35ANMGNTE�t�GRO "
"r r MY COMMISSION 0 GG 0890W
Ft�visad °� crap. .
EXPIRES:A0612 2021 ?• o
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