HomeMy WebLinkAboutCancellation of Permit - 7 PLANNING & DEVELOPMENT SERVICES
- BUILDING & ZONING DIVISION RECEIVED
COUNTY 2300 VIRGINIA AVE
— FORT PIERCE, FL 34982 FEB 2 4 2020
(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-
Contractor.
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: 02/24/2020 Permit Number: 1907-0438
.R
Site Address: 2550 Walton RD
JAK,Inc.dba Applebee Electric State License EC#0002956 SLC License 19055
Original GC,subcontractor or owner/builder
N/A State License SLC License
New GC,subcontractor
Reason for Cancellation Customers Failure to Provide Engineering
The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all
cost r damages arising from any and all claims of action for any reason,which may arise as a result of this change of
ntrac bcontractor or cancellation of permit.A permit cPPAME
ncelled if ork�has been perfo med.
N OF OWNER(or owner/builder) GENERAL CO C R(or new GC,as applicable)52
w z R.Bennett,Administrator John M.Applebee INT NAME
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l7 d .a Q N C a Z
�+-� tate of Florida,County of St.Lucie County State of Florida,County of St.Lucie County
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e following instrument was acknowledged before me this The following instrument was acknowledged before me this a E
w a E 5 4th February zo zam day of Feb nary 20_LO-_by A E-
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o a day of ry 20�by-
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z m .Bennett who is personally known to me John M.Applebee who is personally known to
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Drivers License •..b
"i•.., who hasp ed as ID. me or who h uced as ID.
02/24/2020 ��^ do. 02/24/2020
�e,: gnature of Notary Date Signature of Notary Date H,• '
Revised 04/15/16