HomeMy WebLinkAboutChange of ContractorPlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Contractor is to be completed 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,
signature, and transfer fee. 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. Subcontractor changes can be completed by the general
contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the
owner and qualifier of record.
Date:
Reason for Change
Permit Number: zn s - nog
The 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 contractor/subcontractor or cancellation of
permit. A permit cannot be cancelled if work has been performed.
SIGNATURE F OWNER orr o/wnne�r//bbuilldder) * SIGN URE OF KNEW
GENERAL CONTRACTOR
PRINT NAME _i/1 -G, PRINT NAME
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
`ftday of�� 20," by
' V—wo CS 1�! w""s�he� is personally know to me
has produced,�hLas ID.
Signature of Notary
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of-l-7-1 , 2Q by
who is personally know tome
or who has produce4 as ID.
a�
Signature of Notary Date
*Only signature required fo bcontractor
Revised 07/21/19EqONNotalPublic State of Retitle eft Notary Pubfie State of Fbddo
ah Klatly + Hannah Klatty
mmission GG 929545 } My commission GG DZ9545 %
3111f)62023 ���iii��� Expires 11/081202J