HomeMy WebLinkAboutProject Information PLANNING &DEVELOPMENT
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BUILDING&ZONING DMSIO
2300 VIRGEWA AVE
FORT PIERCE,FL 34982 DEC 14 �2018
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ST. Lucie County,(772)462-1553 FAX 462-1578 7nty _n-
CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OETHE 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 (57,500 if A/C Cbangd=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$50.00 fee for the Change of Sub-
Contractor.
CANCELLATION OF PERMIT—The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit
Date: Permit Number: 1810-0570
Site Address: 2874 HARSON WAY
DONT SWEAT IT AIR AND HEAT,INC State License CAC1818236 SLC License
Original GC,subcontractor or owner/builder
FRITZ HEATING AND AIR CONDITIONNING,LLCS tate License CA01 819179 SLC License
New GC,subcontractor
Reason for Cancellation- IJo-� uk$ivia_ Lo CADV-
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
contra to/subcontractor or cancellation of permit.A permit cannot be ca celleM if work has been performed.
SIG 017113 OrOWNER(oro,64ne(ftilder) SIGNATURE GENERAL 0 T CTOit(or w GC as applicable)
PRINT NAME_�M jr 0–i rf PMT NAME 1ZQ 1 0
State of Florida,County ofSL4Aw4Coot*y PA CM �EAOY State of Florida,County of St Lucie County
The follo%ving instrument was ackmo lodged before me this Th following iopmment Was aCTLml d!gr4"meth' -
w 'en
!V—I'dayof 067e, 20 0 i: f_�=- 2 by Ll
YvLkc�,�Ire _L_by – i)l
�Ilto is personally knoxvit to me F1 who is personallyknourn to
or nbo has produced a,ID who as pr ied as 11).
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a orNotary Date Signature of Notary Date
LINDAAKLEYWEGT
Revised "Arsty P&, KAREN S. NIELSEN
WaryAtibli,-Stateof Florida j.
State of Florida-Notary Public
n. gz Commission#GG 206760 Commission #GG 207484
comm.
Ay Expires Apr 15,2022 My Commission Expires
Bonded through National Notary A June 12, 2022