HomeMy WebLinkAboutMisc Letters -— PLANNING &DEVELOPMENT SERVI CES
BUILDING & ZONING DIVISION RECEIVE
2300 VIRGINIA AVE DEC 0 2 2019
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578 ST. Lucie 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.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a$50.00 fee for the Change of Sub-
Contra tor.
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: 11 aS)19t Permit Number: 1 901_ 09
Site Address: V--\&-CLi-C1rQ�-/ �Ct
QJ0 BeCVner Q '.Se_ x,'e_1CS State License SGCt 31150y�,SLC License
Original GC,subcontractor or owner/builder `/6k
State License SLC License
New GC,subcontractor ^-1
Reason for Cancellation Cil ply COl(�c: le� y' ` ` )-I m9ciAh�
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.
SIGNATURE OF OWNER(or owner/builder) SIG TURE G CONTRACTOR
(or
_new GC,as applicable)
PRINT NAME PRJNTN.AME, ()QCs
State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
The following instrument was acknowledged before me this The following instrument was acknowledged before me this
day of 20�by day of N oU 20M,by Doc, %PaT
who is personally known to me who is Dersonally known to
or who has produced as ID. me or who has roduced as ID. X
Signature of Notary Date o otary Date Q► GO 0
oa z�hoz
Revised 04/15/16