HomeMy WebLinkAboutCancellation of Permit To: Page 3 of 3
2020-05-19 18:33:13(GMT)
From:BILLING OFFICE
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.` BUIL� l�lCC91�i� REGjAAVE
IVES.
'� 462, 553 4627$
.. .. :'...ST..t uCie:Count Pe
Y, rrriitting'.
CTt N(G a d�>ii C�I�T)< A�T�1R S11i$CON°ls"1t2AC.TOR OR C ANCEL:�.rl9rH.i0N OF P1wRMT' . :...' ..
:... .....:...pt` y gl err c�r� OrT'14 Foil ter: :.:
'CHANGE OFC d3NTf2AC�t�R=t.hata e of&tractor''is to be,signed hrld n'otarizecl b 'the ro ow}der,
r by'-the P .lY
and the,new:.coinractor of record for.the`ctarrent permtt.•A:new.permat application_must',alsa be"completed"with.,new
contractor.information aaad,signature.'A new Notice 6I'Commencement must be'-filed itti:tlae ne�u.ct)tltractor',s: a�a►aae,
fear.Igb_valu4s'greater:Haan•'S2',500 {S7;SOO;it';AlC .Change-out). 1 'recorded..oc�py:nxust 'be 'suhinitted prior'
commencing any work.There is a.550.00 fee for the Change of Contractor:
dfAl`I(i tt}t S€,IIfCONTRACTOR ,Subcontractor eltai3ges are:to be compie ed,by°tlt�.general contractor. .
7;he new sFibc.ontractor txtust fi l.out a Stk coria actor hgreeinenc Form.There is h$'50.00 fee.for the.C'hange of Su14-
Contractor,",,'.
4,.
Contractor. ..
�CA�1+�E LLA'TI N,Off{"P�RP�f� -The baacel.lat:ion of:a.permit is.acceptabte:ozaly if no Nvork.has..beeit done.
an eIlation of petfnit is,to.lte' igned and notarized by bgth the�owncr atid.quali ex ttl,recurd..'There is.ino`fee•for`:'.
Vans ellatien of the.peraecit. ', :''
?ate: Namber: 1707-0496 :
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8813 QNE f�.tl1T.RL;Pt)RT.,ST.LUCIE,.Fl 34$8777,
6:.'..:. .._:.'....:
LOWES.....'.,:
State 6 i.cense S:L L icer ae
__.....
mai inatO "subcontractor.oroti!nurlbuilder:
Y19 ,?
"State License: SLC License
New.,CC,'subcontractor:. '
: : . .. . ...... .-. '. ... GHATGED._4UR.aVI.ITI�:=T44. XF?E#VStVE::::.:.
... Reason.for£:ancellation'
The undersigned does hereby agree .t) #i emnify all,bold harmless St"I.itcieCounty,'its.officers,agents atxd,entpioyees from
costs fees or datnagesarising AxQ!n any acid all claims rof action'for any rcttsttn,':YhiGM nay arise as a result.of this claattge of
: .contra ` rlspbc.o or cancellation of penrait A pt*rniit.caniavt be cancelled if wortc.hs.been`.pei formed.
S RE OF: )W R.(or 6ti�ner/builder)• SIGtJATtJRF fi[lTiEt(s11,Cnta'r[�t1CTOat'(ur iteq GC,es n#)piicabte)
.'. ..
:. ; tz.rt�7:ttint Ann-Marla Patera
Pt�iN't'NA VSE.'
State of tarida Counts of St;i.;'s)eie t:oritroty State nfa iorida;County of S#,Lzicie^C'ouniy .
•'`•' : '1'Me fin s+i)�a insuvment.wss acknowtr�l ec1 before nre this :` ... .'"E'hr.fgllow:ing insinin)ent t�_as acknowfeJstul before nit tMis;
�P i4 e �7? wM�.is personally knuuxi to ufe day of i
' ,2C
�rtintr
ar, has roduced'� b�fl-- ,.• u.
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cn:wka)lts nrrxtuct _' is
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S19slature of Notary
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.P.3XI.5 r?d.Ry/15,116 t' • Notity Public--State of plariva
;t:ammission#.GG 338728
Y Comm.Expires Ju(24,,2023
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