HomeMy WebLinkAboutPermit CancellationPLANNING & 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 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 signed by the general contractor only.
The new subcontractor must fill out a Subcontractor Agreement Form which is signed by both the contractor and
subcontractor. 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: / �0
Site Address:
Permit Number:
a60 3 - d �3'5'
6 k:'5 -w h e r- b C, Ntd e, \ State License G M (03 SW/ SLC License
Original GC, subcontractor or owner/builder
State License SLC License
New GC, subcontractor or owner/builder
Reason for Cancellation
The undersigned does hereby agree to indemnify and hold harmless St Lucie C,,77,,((rr�tl.
my, its officers, a e s and a ployees from all
costs, fees or damages arising from any and all claims of action for any ' asonJWhich may arise esult of his change of
contractor/subcontractor or cancellation of permit. A permit cannot ca�rc� III if work has. per I • eth
SIGNATURE OF OWNER (or owner/builder)
PRINT
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
_day of , 20_, by
is personally known to me
or who has produced as ID.
Signature of Notary Date
Revised 05/18/2017
GC, as applicable)
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
1_' _day of , 20 by
hri ti ) (l who is personally knmm to_
Mp or who has produced as in
C%'0& �ttmmn 5-12-2010
Signature of Notary Date
e'0.,, _ Notary Public State of Florida
+ 'F Linda H Broome
My commission GG 224487
erP Expires 08/0912022
TRK
Fort Pierce, FIL 494
Phone:772-466-2400
772-466-3053
1
May 12th ,2020
RE: Permit #2003-0335
Eileen Tilton
5306 Hickory Dr
Fort Pierce, FL 34982
To whom it may concern:
Seacoast Air Conditioning and Sheet Metal, Inc. would like to cancel the above
permit #2003-0335 from address 5306 Hickory Dr Fort Pierce, FL 34982 for the
Duct work change out. The customer has decided not to move forward with the
Duct work. If there is new Duct work at this address it was not done by Seacoast
A/C. If you have any questions or concerns please call our office at
772-466-2400.
Sincerely,
Christopher P. Langel
President
"Don't Roast Call Sea Coast"