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HomeMy WebLinkAboutCancellation of PermitPLANNING & DEVELOPMENT SERVICES - - BUILDING & ZONING DIVISION * 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 FAX 462-1578 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 infonnation and signature. A new Notice of Commencement must be tiled 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. XX 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. 7\,-� Av`\ybZcc,�Q,�et•;vli`43r-,,;PPL-cen, Date: �- 0 (Permit Number: � — ©L(11 U Site Address: XX 1 i (� S n T>r, . "Qc0 PETER CAFARO Original GC. subcontractor or owner/builder N/A New GC, subcontractor State License CGC1508417 State License N/A Reason for Cancellation CUSTOMER CANCELED INSTALLATION SLC License SLC License N/A The undersigned does hereby agree to indemnify and hold harmless St Lucie Coun its of cers, -ents and employees from all costs, fees or damages arising from any and all claims of action for any reason, w is ma arise as result of this chan�-e of contractor/subcontractor or cancellation of permit. A permit cannot be cancel, tf o has bee performed. SIGNATURE OF OW NER (or owner/builder) PRINT NAME State of Florida. County of St. Lucie Countv The Ibllowins instrument %%us acknowledged helbre me this dac of .20 by who is personally known to me or who has pr0[luced as ID. Signature of Notar, Date SIGN i lJR G FRAL CON'TRAC'TOR nc�� GC'. as applicable) PRINT NAM PETER CAF O State of Florid ounty of St. Lucie County 'Ihe followingtrument was acknowledged before me this dac of .20 , b — ID. 01 041 Notary PIblic State of Ronda a4 Kari M Riccabont Pevised 04/15/16 < My Commission FF 981647 a A Expires 05/28/2020 - H