HomeMy WebLinkAboutCounty Change of ContractorPLANNING & DEVELOPMENT SERVICES
- BUILDING & ZONING DIVISION
® 2300 VIRGINIA AVE
s •
" .. "o.y.::=� FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR. SUBCONTRACTOR OR CANCELLATION OF PERMT
PLE4kL SELECT ONE OF THE FOLLOWING:
_ (.'HANGE 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 AFC 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 S50.00 fee for the Change of Sub -
Contractor.
__ __ CANCELLATION OF PERMIT — I he 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: July 1st, 2020
Site Address' 3191 Jet Terrace, FL Pierce, FL 34982
Ahrens Companies; Richard Ahrens
Original GC, subcontractor or owner/builder
Ahrens Companies; Gerald Holt
New GC, subcontractor
Reason for Cancellation
Permit Number: 1812-0471
State License CBC006515
State 1,icense CGCO25760
SI.0 1_icense
SLC License
I'he undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractorsubcontractor or cancellation of permit. A permit cannot b ncclled if work as b n xerformed.
SIGNA RME Oh OWNlilt (or oN%ner/builder) SIGNA l l Rl CI NI RAT. C N'I"KAC fOR (ornelr ,C, us applicuhlet
PRINT NAME PRINT NAME Gerald P. Holt
State of I londa, COLInt} OfSt I tncLe C oum
Tre follomnng instrument this uckno%%lodged betore me this
da} of 20_ h}
echo is personalh known to Ine
or %%ho has produeed _. ._us Ib
July 1st, 2020
Signature of Nolan- Date
State of I londa Count) of t sx,r-l+mm!'Qal'h6.O..h
'fhc folloumg I slnuncnt ��as acknrnnkdgcd bcli,rc Inc this
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{., July 1st, 2020
Signature of Notar►Q Date
ti r MICHELE BALL-VAUGHN
Revised 04/15/16 NOTARY PUBLIC
x —STATE OF FLORIDA
? Comm# GG132424
1 Expires 9/21/2021