HomeMy WebLinkAboutMisc Letters 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.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a$50.00 fee for the Change of'Sub-
Contractor.
!"'d 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; 10/30/2019 Permit Number' 1908-0567
Site Address' 9629 Fairwood Court,Port Saint Lucie,FL 34986
State License SLC License
Original GC,subcontractor or owneribuilder
State License SLC License
New GC,subcontractor
Reason for Cancellation Customer not moving forward with the work
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
contractor/subcontractor or cancellation of permit.A permit cannot be cancelled if work has been performed.
MiYanda
SIGNATURE OF OWNER(or o r/builder) SIGNATURE GENERAL CONTRACTOR(or new GC;as applicable)
PRINT NAMEDaniel Deering PRINTNAME Don Miranda
State of Florida,County of St Lucie County State of Florida,County of St Lucie County
Y' d
owing nt was acknowledged b re me this a oll win in twnent tvas acknowled fore
ay of ! ��20 by J / 6 I 10V ofG6�7✓20 byg
e�,Gx who.is pe orally known me who is p onally kno to
or �produ_c_e�dlas ID. me o who has produced as/30/2019 9� 0/30/2019
ignature of Notary Date i tnre-of Date
Revised 04/15/16 "k;Cft MC
MWM
z Comm,#00358475
*-BEW dT �NOV-Ann�tlo�ry