HomeMy WebLinkAboutMisc Letters _ PLANNING & DEVELOPMENT SERVICES
_,r< BUILDING & ZONING DIVISION RECEIVED
'iCOUNTY 2300 VIRGINIA AVE
FORT PIERCE, FL 34982 FEB 2 5 2019
(772) 462-1553 FAX 462-1578 51 lwcle 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.
The5AENC=ELLATION
r must fill out a Subcontractor Agreement Form. There is a$50.00 fee for the Change of Sub-
Co
OF PERNUT—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: t 'tac5 l Permit Number:
Site Address: _N � I
State License W M SLC License Q T Z—
Original GC,subc ntractor or o er/builder
State License SLC License
New GC,subcontractor
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
costs,fee damages arising from any and all claims of action for any reason,which may arise as a result of this change of
contra oris bcontractor or cancellation of permit.A permit cannot b a celled if work has been performed.
SIG ATU O (o owner/builder) SI A COl� CTOR(ornew GC,as applicable)
PRI Y P AME_C�V a t Q M O IO 1 e Y
State of Florida,County of St.Lucie County State of Florida,County of SL_Lucie County
The following instrument was acknowledged before me this The following instrument was acknowledged before me this
ZJ_rndayof_ ebYua 0._t ,by 1'a Z �Yof EGbCU1t')20g,by
0 who is personally known to me t who is personally known to
or who pr ced as ID. as lD.
2 t q / 25 20 tq
st a of Notary Date SI r of Notary Date
Revised 04/15!:6