HomeMy WebLinkAboutlawn mower shop change of contractor.i&'1",al.,t:1 Gt F ".
COUNTY .
FLORIDA
Planning & Development Serv ice s
Building & Code Regulations Divi sion
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
CHANGE OF CONTRACTOR
Or Subcontractor or Cancellation of Permit
Change of Co ntrac tor is to be completed by the property owner , and the new contractor of record for th e
current permit. A new permit application must also be completed with new contraclor inform at ion,
signature , and transfer fee. A new Notice of Commencement mu st 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 co mpl ete d by th e ge nera l
contractor . Absent extenuating circumstances, a cancellation of perm it is to be exec uted by both the
owner and qualifier of record.
Date: 8/4/2020 Permit Number: _2_0_02_-_05_0_5 _____ _
Site Address: 7159 SUS HWY 1
_A_s_su_r_ed_C_o_n_tr_ac_t_in_g_L_L_C __________ State License ______ SLC License ___ _
Original General Contractor (or Subcontractor)
_l_nn_o_v_a_tio_n_C_o_nt_ra_c_ti_n_g_L_L_C _________ State License CGC1511910 SLC Licens e ____ _
New General Contractor (or Subcontractor)
Reason for Change Job Is to fare away for contractor owner requested change
The undersigned do es hereby agree to indemnify and hold harml ess St. Luci~unty , its officers,
agents, and em~loyees fr~m all costs, fees , o_r dam ages arising from any Jlld all claims of ac tion for
any reason, whtch may anse as a result of this change of contr ;io r~ul5contractor or cancell at ion of
permit. A permit cannot be cancelled if work has been perfo r /
SIGNATURE OF OWNER (or owner/builder)
PRINT NAME _________ _
State of Flori da, Co unty of St. Lucie Co unty
The fo ll ow ing instrument was acknow ledged before me this
__ day of ___ ~20~ by ___ _
________ who is personally know to me
or who has produced ____ as ID .
Signature of Notary Dat e
*Only signature required fo r change of
Revised 07 /21/14
R
ment was acknowled~j d before rr_:Jh,i)J
-""l-~2cl__]__, by la ,~I v!Jf!Jr/J
who is personally know to me