HomeMy WebLinkAboutMisc Letters PLANNING &DEVELOPMENT SERVICES.
5. `11M =` BUILDING& ZONING DIVISION
2300:VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 FAX 4624578
CHANGE OF CONTRACTO , SUBCONTRACTOR OR. CELLATION.OF'PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE OF CONTRACTOR—Change of'Contractor.is to._be signed and:notarized by=the proper ,y-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 f.11 out.a-:Subcontractor AgreementYorm.There is'a$50.00 fee for the Change of'Sub-
Contkacto
CANCELLATION OF PERMIT—The cancellation of a perp itis acceptable--only—if no work has been done.
Cancellation of permit.is to;be.signed and notarized by both the owner and qualifier'of record..There is no,fee for
ad cancellation of.the permit.
.Date: Permit Number: 1. 6
Site Adressc`
l PL,3a;40
J.
Lj&__�W(. State.Licens .... ..j WC License:.
Orig4i.GC,subcontractor or owner/builder
State:License SLCUcense:
New GC,subcontractor
Reason for-Cancellation cL M61 ( ,
The undersigneddoes:hereby agree to indemnify`and`holdharniless St Lucie County;its officers,:agentt ond:employees from all
costs,.feesor damages arising from any and alf-'claims-of action for anyreaso 'which may arise asA result,oftl igchange of
contrac r/subcontractor or cancellation of.permt:;A:permit cannot`be`es ' ell if Work has been,performed.
G' TON OF OWNER(or°o rlbuilder) SIGNATURE G NTRACTOR(or: ew GC,;as applicable
PRINT 'NAME Cis!\ PRINTNAME. -
State of,Florida,County of St Lucie:Coun tate of Florida;:County of St Lucie County
owing'estrument was aaltnowledged before me this. ThSrfollowing instrument aclmowledg efore me this
day of 2011Y ;b E day of r 20 1$by
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esu C/ a onali owa fo a �. who i ersonall. •� to
whoas rs .y p y _
Or� o has produced- as• i' C me o who has.produced as,
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Signature ofNotary. Date Signature df Notary Date
Revised 04/ � �w kole McMahon V.'��1�r,� Nicote'McMahon
;]:5/1• ommission IFF945187 -KCommission ¥ 0945187
E Oke'`November 19,2019`• , Expires:-November'19,2019
ix �' Bonded thr9 kion Notary -- Bonded thru Aaron,Notary.
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