HomeMy WebLinkAboutCancellation NoticePLANNING & DEVELOPMENT SERYICES
;uliunqc & zoNING DIvISIoN
23OO VIRGINIA AVE
FORT PrERcE, FL 34982
oil +az-lss3 F'Ax 462-1578
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m:H:Hfr[l:ll1'SHi:i"ffi"1l"',i#':]t":#"Hffirffii""nr1['i"n"**'o"tu'tor's
name
for job values gr*or*;o*sz,soo ($?,500 il'nli crr*ee-o.rr). e-*oio.a copy must be submitred prior to
oommencing any worlc int"t is a SSO'OO fee for the Change of Contractor'
.HAI{GE OF suBcoNTRACTOR - Subcontractor changes are to be compreted by the general contaotor'
Th-" ne* subcorfiractor must fi, out a subcontru"t* eg****ot ror*. fr*ie is a $50"00 fee ior the change of sub-
x.':ixcELLATION OF pERVIrr_- The canceuation of a permit is acceptabre only if no work has been done'
Cancellation of permit is to be signed *O,ot"i'"0 by both tftt o*#-*J qoifin*t of iecord' Therc is nQ fee for
Permit Number:
Licens SLC License
0
PRINT NAME
State ofFlorida, County of$t Lucie Courty
The followine imtrumenrvras acknqvledged betbre me this
4-a* "t--@b-zol-I-tv--
cancellation gf the Permit.
Date:
Address:
\s c0llr
O.igir"I Gq subcbntractor or owner/builder
New GC, subcontractor
Reason for Cancellation
T ' agents and emPloYees from all
oosts, foes or damages arising ftom any and ail craims of action for auy reason, which may arise as a result of this change of
oi c;ncef6ion .of permit. A permit cannot be cancelled lf work has been performed.
Stde of Floridq Coudy of St Lucic County
y&o is personally knorruto mo
producad-----as ID'
CADi*gRINE MILLER
State ol Florida-Norary pubti
Commission # GG 2733 I sMy Commission Exoires
Novdmber 01 .2022
CATHERINE MILLEE
-NotarV Public
Commission # GG 27G31 sMy Commission Expires
November 01 ,2022