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HomeMy WebLinkAboutCancellation of Permit& DEVELOPMEN7f SERVICES
G & ZONING DIN ISION
2300 1 TRGENIA AVE
FORT PIERCE, FL 34982
(772) 62-1553 FAX 462-1578
U
CHANGE OF CONTRACTOR --
and the new contractor of record for the curt
contractor information and signature. A nev
for job values greater than $2,500 ($7,54
commencing any work. There is a $50.00 f
CHANGE OF SUBCONTRACTO
The new subcontractor must fill out a Subcc
11
`,hange of Contractor is to be sued and notarized by the property owner,
nt perrn.F,t. A, new permit application must also be completed Urth new
Notice of Commencement must be filed in the new contractor's name
if A/C Change -out). A recorded copy must be submitted prior to
for the Change of Contractor.
-- Subcontractor changes are to be completed by the general contractor.
tractor Agreement Form. There is a 550.010 fee for the Change of Sub -
Contractor.
— CANCELLATION OF PERK T — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be sued and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 05113/2020
Site Address: 356 E Midway Rd/Fort Pierce, FL
T reesure Coast C3ener3i Contractors, LLC
Origiaial GC, subcontractor or
New GC, subcontractor
Reason for Cancellation Health Department R(§quirerrients
Perri -it Number: 2003-0520
License CGC1526542 SLC License
License SLC License----
The
icense___
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officets, agents and employees Bram all
costs, fees or damages arising from any and all claims of actia n for any reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be eanc ed 'f w©rk has -n p rformed.
ST(NA-nJR 1~ ovl xfi (o wnerlbuilder) SiGNAT Al (TK-ii:RAL CONTACTOR for new CSC, as applicable)
PRINT k;: -
State of l:lorida, County of St.. Lucie Caumy
The SoUowing instrument was ac1m(nale,iged before me this
130' day of. May 20 2" , by —Jl- fr
Tw+o is pmottaily krimm to
or s rced ci as 33)..
05[1312020
Signature of Notary wt.
Revised 04133' Wft Notary Public State of
Colleen sus Mayes
p� My Commission GG 2
prntl' Expires 03/15/2023
PRiJTNAMB E evin Wheaton
Stale of Florida, County o; St_ Lucie Cour.+
The foUov; ing insm=ien.t was acknowledged bdore rue this
w[ o is prrsonaly known, to
rre produced p'- as1).
t35MW2020
Sigrivur•e of NNOWN date
04AY � Notary Putdic State of Florida
r Colleen Sue Hayes
r My Commnswn GG 287729
'dta n Expir 03!15!2023